Abstract: SA-PO1125
Evaluation of Safety and Adherence in Cytomegalovirus Prevention After Kidney Transplantation: A 10-Year Single-Center Experience
Session Information
- Transplantation: Clinical - Infectious Diseases
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Morales Buenrostro, Luis Eduardo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
- Siguenza, Nube, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
Background
Cytomegalovirus (CMV) remains one of the most common infectious complications after kidney transplantation. Universal prophylaxis and preemptive therapy are the main prevention strategies currently used; however, comparative data regarding adherence and safety in Latin American transplant centers are still limited.
Methods
We conducted a retrospective single-center cohort study including adult kidney transplant recipients between 2015 and 2024 at a tertiary referral center in Latin America. Patients received either preemptive therapy or universal prophylaxis according to institutional protocols and CMV risk stratification. Primary outcomes included adherence and safety. Secondary outcomes included CMV infection, CMV disease, immunosuppression reduction, opportunistic infections, acute rejection, graft survival, and mortality.
Results
A total of 288 kidney transplant recipients were included: 157 received preemptive therapy and 127 universal prophylaxis. Overall adherence to CMV prevention strategies was 82.4%. Adherence was higher in the universal prophylaxis group than in the preemptive therapy group (89.8% vs. 76.4%, p=0.003). Patients receiving preemptive therapy had fewer adverse events (19.1% vs. 33.1%, p=0.034) and lower rates of immunosuppression reduction due to hematologic toxicity (3.2% vs. 14.2%, p<0.001). Mortality was lower in the preemptive therapy group (1.3% vs. 7.1%, p=0.012). CMV infection occurred in 19% of patients, with no significant differences between groups, while CMV disease remained uncommon (3.5%). Late CMV infection was observed only in the universal prophylaxis group. No significant differences were observed in graft or patient survival during follow-up.
Conclusion
Universal prophylaxis achieved higher adherence, while preemptive therapy was associated with fewer adverse events and less immunosuppression reduction. CMV-related outcomes were similar between strategies.
The choice of CMV prevention strategy should consider both patient risk and institutional monitoring resources.