ORIGINAL RESEARCH article
Front. Transplant.
Sec. Transplantation Immunology
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1647725
Graft dysfunction is associated with late CMV infection after kidney transplantation: Manuscript
Provisionally accepted
- Department of Nephrology, Royal Melbourne Hospital, Victoria, Australia
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Background: Cytomegalovirus (CMV) causes significant morbidity and mortality following kidney transplantation. Late CMV infection (≥2 years post-transplant) is uncommon, and its risk factors and outcomes may differ from earlier infection. Methods: We conducted a single-centre retrospective study of kidney transplant recipients between 2009 and 2019. Patients were grouped by CMV status: no infection, early infection (<2 years post-transplant), and late infection (≥2 years post-transplant). Clinical characteristics and outcomes were compared. Results: Donor-positive/recipient-negative (D+/R−) serostatus was observed in 105/710 (14.8%) patients without CMV, 28/42 (66.7%) with early CMV, and 2/28 (7.1%) with late CMV (p<0.001). Prior rejection occurred in 5.9%, 16.7%, and 10.7% respectively (p=0.017). Median serum creatinine was 113, 127.5, and 219.5 µmol/L respectively (p<0.001). CMV serostatus was significantly associated with early infection (p<0.001), while only serum creatinine was associated with late infection (p=0.003). Trends were seen toward better one-year patient survival (97.6% vs. 85.7%, p=0.057) and graft survival (88.1% vs. 71.4%, p=0.073) after early versus late infection. Conclusions: Risk factors for CMV infection differ by timing post-transplant. Renal dysfunction may be a key predictor of late infection. Identifying at-risk patients may support targeted surveillance and improve long-term outcomes.
Keywords: late cmv infection, renal failure, Kidney Transplantation, cytolomegavirus infection, Graft Survival
Received: 16 Jun 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Zeng, Barraclough, Lian, Masterson, Hughes and Chow. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Angela Zeng, angela.zeng@mh.org.au
Kevin V Chow, kevin.chow@mh.org.au
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