Positive donor and negative recipient cytomegalovirus status is a detrimental factor for long-term renal allograft survival.

In 524 allogeneic cadaveric kidney transplants, the impact of cytomegalovirus (CMV) donor/recipient status on the incidence of CMV infection, CMV disease, early and long-term graft, and patient survival have been analyzed with respect to rejection episodes. Most CMV infections (59%) and diseases (17%) were found in CMV-negative recipients of CMV-positive kidneys. The 1-year function rate of CMV-positive kidneys (75%) dropped about 10% below that of CMV-negative organs (85%), and in the case of CMV-negative recipients an additional graft loss of more than 10% happened within the 4th and 5th years (5-year graft survival pos./neg.: 56%). This detrimental effect was exaggerated if it coincided with antibody-treated rejection episodes.