CMV Infection and Lymphopenia: Warning Markers of Pneumonia in Kidney Transplant Recipients.
Fiche publication
Date publication
janvier 2024
Journal
Transplant international : official journal of the European Society for Organ Transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BINQUET Christine
Tous les auteurs :
Eberl I, Binquet C, Guilloteau A, Legendre M, Dalle F, Piroth L, Tinel C, Blot M
Lien Pubmed
Résumé
pneumonia (PcP) remains life-threatening in kidney transplant recipients (KTR). Our study investigated risk factors one-year before PcP. We conducted a monocentric, case-control study including all KTR at the Dijon University Hospital (France) with a diagnosis of PcP between 2005 and 2022 (cases), and matched control KTR with no history of PcP (3 controls/case). Among all 1,135 KTR, 57 cases (5%) and 169 matched-controls were included. PcP was associated with 18% mortality. Compared to controls, cases were older, with a higher immunological risk, and CMV infection was more frequent in the year preceding the occurrence of PcP (23% vs. 4%; < 0.001). As early as 1 year before PcP, lymphocyte counts were lower and serum creatinine levels were higher in cases, but immunosuppressive regimens were not significantly different. Multivariable analysis identified lymphocyte count, serum creatinine level, being treated by immunosuppressive therapy other than anti-rejection drugs, and CMV infection in the year preceding the time PcP as independently associated with the occurrence of PcP. PcP was associated with an increased risk of subsequent chronic rejection (27% vs. 3%; = 0.001) and return to dialysis (20% vs. 3%; = 0.002). The occurrence of CMV infection and a low lymphocyte count could redefine the indications for continuation or reinitiation of anti- prophylaxis.
Mots clés
CMV, kidney transplantation, lymphopenia, pneumocystis, pneumonia
Référence
Transpl Int. 2024 01 24;37:12192