Cytomegalovirus Infection Does Not Accelerate Microvasculopathy Development in Heart Transplant Recipients

• Published in: Transplantation proceedings Vol. 41; no. 8; pp. 3219 - 3221
• Main Authors: Zakliczynski, M, Krynicka-Mazurek, A, Konecka-Mrowka, D, Nozynski, J, Żegleń, S, Przybylski, R, Zembala, M
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01-10-2009; Elsevier
• Subjects: Adult; Antigens, Viral - blood; Biological and medical sciences; Biopsy; Case-Control Studies; Cohort Studies; Cytomegalovirus Infections - complications; Cytomegalovirus Infections - pathology; Cytomegalovirus Infections - physiopathology; Disease Progression; Endothelium, Vascular - pathology; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - epidemiology; Heart Transplantation - adverse effects; Heart Transplantation - pathology; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue, organ and graft immunology; Vascular Diseases - epidemiology; Vascular Diseases - pathology; Vascular Diseases - physiopathology; Viral diseases; Heart; Herpesviridae; Transplantation; Homotransplantation; Betaherpesvirinae; Human cytomegalovirus; Infection; Virus; Medicine; Treatment; Surgery; Viral disease; Development; Graft; Circulatory system
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2009.07.068

Abstract Background Clinical studies with intravascular ultrasound have suggested that even subclinical cytomegalovirus (CMV) infections increase intimal hyperplasia in transplanted heart coronary arteries after 1 year. The potential influence of CMV on microvasculopathy development is not known. The Aim of our study was to compare the occurrence of microvasulopathy in endomyocardial biopsies (EMBs) of heart transplant recipients with versus without CMV infection. Materials and Methods We performed a case-controlled, retrospective study of 58 subjects diagnosed with CMV infection by the presence of pp65 antigen. The 49 men and 91 women of overall age 49 ± 8 years showed ischemic cardiomyopathy in 52%. We matched a control cohort of 58 subjects without CMV disease. Microvasculopathy was assessed using 4-degree grading system developed by Hiemann et al for elective EMBs performed at 1 and 12 months after transplantation. Results Significant acute rejection episodes were observed among 22% versus 21% of 1-month EMBs, and 3% versus 5% of 12-month EMBs for CMV(+) versus control group subjects respectively. The commonest microvasculopathy was nonstenotic thickening (grade B) 60% versus 59% (35 versus 34 patients) among 1-month EMBs; and 50% versus 60% (29 vs 35 patients) among 12-month EMBs, respectively. Progression of microvasculopathy score between 1- and 12-month EMB was observed in 40% versus 41% of subjects, and regression occurred in 22% versus 21%, respectively. None of differences was significant. Conclusion Our data do not support the thesis that CMV infection promotes microvasculopathy development among heart transplant recipients.