Infectious Complications of Induction Therapies in Kidney Transplantation.

Abstract

Background: Cytomegalovirus (CMV) and BK virus (BKV) are post-transplant opportunistic viral infections that affect patientand graft survival. This study was designed to evaluate the risk of BKV nephropathy and CMV disease in kidneytransplant recipients who received induction therapy with ATG or basiliximab.Material/Methods: We retrospectively analyzed information on 257 adult patients who underwent kidney transplantation betweenJanuary 2007 and 2017. Patients were categorized into 3 groups according to the induction therapies. The primaryendpoint was the onset of CMV disease or biopsy-confirmed BKV nephropathy. The secondary endpointswere biopsy-proven rejection episodes, graft loss, loss to follow-up, and death.Results: We followed 257 patients for a median of 55.5 months. The incidence of CMV disease was significantly higherin the only ATG group compared to the group without induction treatment (p<0.001). There was no significantdifference in the incidence of BKV nephropathy among groups (p>0.05). The dosage of ATG (OR, 10.685; 95%CI, 1.343 5 to 85.009; P=0.025) was independent risk factor for death.Conclusions: This study demonstrated that a higher dosage of ATG in high-risk patients is associated with an increased riskof CMV disease and patient death, also, reducing the dosage may be a rational strategy for increasing graftand patient’s survival.