Abstract: FR-OR084

Kidney Transplant Allocation with CMV Seromatching Reduces CMV Infection

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Norman, Douglas J., Oregon Health and Science University, Portland, Oregon, United States
  • Langewisch, Eric D, University of Nebraska Medical Center, Omaha, Nebraska, United States
  • Lockridge, Joseph B., None, Tualatin, Oregon, United States
Background

Cytomegalovirus (CMV) infection is a major cause of morbidity in kidney transplant recipients. A pre-transplant allocation strategy by matching deceased kidney donors and recipients by CMV serostatus may reduce CMV infection.
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Methods

We adopted a CMV seromatching allocation policy within our Organ Procurement Organization (OPO) beginning 09/01/2012. In this retrospective analysis of 400 consecutive deceased donor kidney transplant recipients, we compared rates of CMV syndrome between a historical control (PRE: 1/1/2010 – 8/31/2012) versus after the CMV matching protocol (POST: 9/1/2012 – 12/3/2014). Wait times in the OPO were reviewed after the protocol was implemented.

Results

CMV matching decreased the number of high CMV risk (donor seropositive / recipient seronegative) transplants from 17.3% to 2.5% (p<0.001) and increased the number of low CMV risk (donor seronegative / recipient seronegative) transplants from 16.3% to 23.5% (p=0.072) (Figure 1). CMV viremia was reduced from 13.3% to 5.9% (p=0.0118) while CMV syndrome or disease decreased from 9.2% to 2.9% (p=0.008). After the allocation change, median waiting times for all deceased donor recipients in the OPO did not increase and appeared to be consistent with national and regional trends (Figure 2).

Conclusion

CMV seromatching optimizes high and low risk CMV profiles and significantly reduces the rate of CMV infection without appearing to disadvantage wait times for recipients

Median Wait Times For Deceased Donor Kidney Recipients
(days) after CMV Allocation Change