[Frequency of infection with cytomegaloviruses (CMV) following kidney transplantation and initial experiences with CMV gamma globulin prevention].

In a retrospective study we investigated 364 patients who had received cadaveric kidney transplants between 1978 and 1984 as to cytomegalovirus (CMV) infections using complement-fixation test and indirect immunofluorescent test (IgM, IgG). Before transplantation, 194/364 patients were seropositive and 170/364 were seronegative. After transplantation, seroconversion or an increase in titre (greater than or equal to 4 fold) was found in 26% of seropositive recipients and in 30% of seronegative recipients. In contrast to the secondary infections (approximately 40% asymptomatic or oligosymptomatic), the primary infections were regularly connected with a clinical symptomatology. As to the recipient's and donor's pre-transplant antibody status the highest infection rate (62%) was seen in the group of seronegative recipients of kidneys from seropositive donors. Preformed CMV antibodies seem to be useful in preventing severe CMV-diseases. Therefore, in April 1985 we started a randomized study in order to investigate the efficacy of an i.v. cytomegalovirus-immunoglobulin (CMV-Polyglobin/Cutter). There were no side effects. Already 4 h after infusion we were able to detect CMV-IgG-antibodies (IFT) in peripheral blood. This passive immunization, however, was not capable to prevent a CMV infection in each case; there were 5/8 seroconversions and 4/8 symptomatic CMV infections. Nevertheless, we think the application of CMV immunoglobulin has a beneficial effect.