POSTTRANSPLANT CYTOMEGALOVIRUS DISEASE

in this study patients with cytomegalovirus(CMV) disease among 548 renal transplant patients being followed up at our clinic during 1983-1998, were evaluated.

Eight patients (%1.4) had active CMV disease. The average period of time between the transplantation and the infection was 5.3±3.2 months As an extra immunosupressive therapy two patients received ATG, two ALG and one patient high dose methylprednisolone. Cytomegalovirus serology was positive two sided in two patients who had their transplantations in our unit. There were not sufficient data about other patients and their donors. Six of the patients had pneumonia, one patient had hepatitis and pnemonia and one of them had acute lower gastrointestinal system bleeding. Though immunosupressive therapy was tapered to minimum during the infections, no allograft dysfunction was observed. Two patients also had pnemonia due to Pneumocyctis carinii and other agents and three patients had apperent bone marrow supression. Six patients were diagnosed by CMV- Ag positivity in serum, 2 by CMV-Ag positivity in bronchoalveolar lavage and 2 by both CMV-Ag positsivity in serum and histopathology. Seven patients were treated with gancyclovir and nonspesific gammaglobulin and one with gammaglobulin only. The patient with lower gastrointestinal bleeding had an operation and received gancylovir therapy. While three patients died, all other patients survived.

It is concluded that CMV disease presents differently in clinic and the mortality rate is high among renal transplant patients. It was noteworthy that though immunosupressive therapy was tapered off there was no allograft dysfunction.