Key result
High anti-CMV IgG titer linked to ~277% greater CMV disease risk after kidney transplant.
Why the study?
The relationship between anti-CMV IgG titer and outcomes such as CMV disease, allograft rejection, renal function decline, and mortality in kidney transplant recipients was not well known.
Does high anti-CMV IgG titer predict CMV disease, allograft rejection, and renal function decline in CMV-seropositive kidney transplant recipients?
Cohort (n=179)
Does high anti-CMV IgG titer predict CMV disease, allograft rejection, and renal function decline in CMV-seropositive kidney transplant recipients?
In kidney transplant recipients, a high anti-CMV IgG titer is a significant predictor of CMV disease, allograft rejection, and renal function decline.
Answers are grounded in this paper and cite their sources.
High anti-CMV IgG titer was associated with higher CMV disease and rejection risks in kidney recipients; leaves open whether titer-guided strategies improve outcomes.
BACKGROUND: An anti-cytomegalovirus (CMV) immunoglobulin G (IgG) antibody is produced after primary CMV infection and generally persists after the primary infection. However, it is not well-known about the relationship between anti-CMV IgG titer and outcomes in kidney transplant recipients. We, therefore, aimed to explore the role of anti-CMV IgG titer on the risks of CMV disease development, allograft rejection, renal function decline, and mortality. METHODS: In a hospital-based study, we identified 179 CMV-seropositive kidney transplant recipients between January 2013 and December 2017. These patients were divided into low and high anti-CMV IgG titer groups, respectively. The cutoff level of anti-CMV IgG titer was determined by receiver operating characteristic curve analysis. The outcomes evaluated included CMV disease, decrease of ≥15% in estimated glomerular filtration rate (eGFR), biopsy-proven allograft rejection, and all-cause mortality. RESULTS: The high anti-CMV IgG titer group (≥846.2 AU/mL) exhibited a higher risk of CMV disease (adjusted hazard ratio [aHR], 3.77; 95% CI, 1.47-9.68; p = 0.006), eGFR decline ≥15% (aHR, 2.00; 95% CI, 1.19-3.35; p = 0.009), and renal allograft rejection (aHR, 2.95; 95% CI, 1.11-7.87; p = 0.030) than the low titer group (<846.2 AU/mL). CONCLUSION: In kidney transplant recipients, a high anti-CMV IgG titer was associated with higher risks for developing CMV disease, undergoing allograft rejection, and eGFR decline.
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Chen et al. (2021) conducted a cohort in CMV-seropositive kidney transplant recipients (n=179). High anti-CMV IgG titer (≥846.2 AU/mL) vs. Low anti-CMV IgG titer (<846.2 AU/mL) was evaluated on CMV disease (aHR 3.77, 95% CI 1.47-9.68, p=0.006). High anti-CMV IgG titer was associated with a higher risk of CMV disease compared to low titer in kidney transplant recipients.
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