Use of intravenous immunoglobulin prophylaxis for primary cytomegalovirus infection post living-related-donor renal transplantation
Steinmuller, D.R.; Graneto, D.; Swift, C.; Novick, A.C.; Streem, S.B.; Cunningham, R.J.; Hodge, E.; Bretan, P.
Transplantation Proceedings 21(1 Pt 2): 2069-2071
1989
ISSN/ISBN: 0041-1345 PMID: 2540554 Document Number: 4863
Patients who receive renal transplants are at risk for transmission of infections with the transplanted donor organ. Cytomegalovirus infection has been shown to be transmitted by the donor organ. Thus, patients who have never been exposed to cytomegalovirus as evidenced by negative serologic studies prior to transplantation, who receive a renal transplant from a donor who has previously had this infection are at risk for developing primary cytomegalovirus infection in the early post transplant period. Primary CMV infection is often more severe and symptomatic than secondary infections. Immunocompromised patients with CMV infections are at risk for developing potentially serious and life-threatening complications from this infection including leukopenia, hepatitis, pneumonia, colitis and enteritis, encephalitis, and retinitis. A recent study by Snydman et al. has documented the beneficial effect of hyperimmune globulin infusions on reducing the severity of primary CMV infection post renal transplantation in patients at risk for primary infection. A study in bone marrow transplant patients has also documented the benefit of the commercially available immunoglobulin preparations in preventing the more serious complications of CMV. This study was undertaken in an attempt to document the benefit of commercially available immunoglobulin preparations in modifying the course of primary CMV infection after renal transplantation. At the present time patients who are serologically CMV negative and who receive blood or kidneys from a CMV positive donor should receive immunoglobulin infusions to help modify the course of this potentially serious and life-threatening infection.
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