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21 May 2009

Cytomegalovirus infection does not accelerate microvasculopathy development in heart transplant recipients

M Zakliczynski, A Krynicka-Mazurek, D Konecka-Mazurek, J Nożyński, S Żegleń, R Przybylski, M Zembala

Ann Transplant 2009; 14(1): 32-32 :: ID: 880313


Background: It was confirmed in clinical studies with intravascular ultrasound
that even subclinical cytomegalovirus (CMV) infection may increase intimal
hyperplasia in transplanted heart's coronary arteries, which is observed at the end of the 1st year after the surgery. A potential influence of CMV on development of microvasculopathy is not known. Aim of the study was to compare occurrence of microvasculopathy in endomyocardial biopsies (EMBs) of heart transplant recipients with or without CMV infection.
Material/Methods: We performed a case-control retrospective study involving 58 pts. with CMV infection confirmed with the presence of pp65 antigen (49M/9F, 49±8y/o, ischemic c-pathy in 52%) and matched 58 control without CMV disease. Microvasculopathy was assessed using 4 degree grading system developed by Hiemann et al. in elective EMBs performed 1 month and 12 months after transplantation.
Results: Significant acute rejection was observed in 22 vs. 21% of 1st month's EMBs, and 3 vs. 5% of 12[sup]th[/sup] month's EMBs in CMV(+) and control group, respectively. Maximal microvasculopathy score was 2.05±0.93 vs. 1.88±0.94 in 1st month's EMBs, and 2.29±1.12 vs. 2.28±1.20 in 12[sup]th[/sup] month's EMBs, respectively. Progression of microvasculopathy score between 1st month and 12th month's EMBs was observed in 40 vs. 41% of pts, and regression occurred in 22 vs. 21% of pts, respectively. None of the differences was statistically significant.
Conclusions: Our data does not support the thesis that CMV infection promotes development of microvasculopathy in heart transplant recipients.

Keywords: CMV infections, Heart Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358