VIRAL-INFECTIONS IN RENAL-TRANSPLANT DONORS AND THEIR RECIPIENTS - PROSPECTIVE-STUDY

Abstract

The majority of renal allograft recipients develop viral infections, usually with cytomegalovirus (CMV). Their source of virus is not defined clearly; 1 possibility is the transplanted kidney itself. To explore this, prospective viral studies were performed on 28 living related donor-recipient pairs. Donors did not have clinical illnesses and viruses were not recovered from throat, urine or renal tissue, but 5 (18%) had 4-fold rises in antibody titers to herpes group viruses. During the 6 mo. after transplantation, 24 recipients (86%) had viral infections, 18 of which were associated with CMV. There was no correlation between specific titer rises in the donors and infections in the recipients. Recipients with dual viral infections had more severe clinical courses than those with single infections or with no infection. Recipients with complement-fixing (CF) antibodies to CMV pretransplant had a higehr incidence of CMV infections than recipients without pretransplant antibody. Of 7 recipients who lacked CF antibody to CMV and whose donors were seropositive, 3 developed clinical illnesses associated with CMV. Latent virus might have been transmitted with the transplanted kidney in these instances, but since lack of CF antibody does not rule out previous CMV infection, the CMV could have been of recipient origin. The donor organ is probably a source of virus for few renal transplant recipients.