Sirapob NuansriSurasak KantachuvesiriSiriorn P. WatcharanananCharat ThongprayoonWisit CheungpasitpornJackrapong BruminhentFaculty of Medicine Ramathibodi Hospital, Mahidol UniversityMayo Clinic2022-08-042022-08-042021-09-01Transplantation Proceedings. Vol.53, No.7 (2021), 2267-227118732623004113452-s2.0-85112574852https://repository.li.mahidol.ac.th/handle/20.500.14594/77906Background: Late-onset cytomegalovirus (CMV) infection (LCI) has been emerging mong solid-organ transplant recipients. We explored clinical characteristics, risk factors, and outcomes of LCI in kidney transplantation (KT) recipients. Methods: A retrospective study of all adult KT recipients with LCIs (that occurred >6 months after transplant) from 2016 to 2018 was conducted. Clinical characteristics and outcomes were extracted. Risk factors of LCI were analyzed using Cox proportional hazards models. Results: A total of 518 KT recipients were included. Ninety-eight percent had donor CMV-seropositive and recipient CMV-seropositive status (D+/R+). Ten (2%) KT recipients developed LCI with a median onset of 14 (interquartile range, 8-15) months. Those included asymptomatic CMV infection (40%) and tissue-invasive disease (60%). CMV D+/R– serostatus and a prior episode of rejection within 6 months were associated with LCI (hazard ratio, 17.35; 95% confidence interval, 3.60-83.63; P < .001) and (hazard ratio, 38.15; 95% confidence interval, 6.15-236.72; P < .001), respectively. There was no difference in the rate of allograft failure and mortality in those with LCI compared with those with early-onset CMV infection. Conclusion: LCI is uncommon after KT. Those with CMV seromismatch and a prior episode of rejection were more likely to develop LCI. Clinical and allograft outcomes were not different among each group.Mahidol UniversityMedicineArticleSCOPUS10.1016/j.transproceed.2021.07.033