The incidence and outcome of cytomegalovirus (CMV) infection and disease is compared in renal transplant recipients in relation lo the use of prophylaxis wiU1 high titre anti-CMV immunoglobulin. Seventy-three CMV-negative recipients (R-) who received kidneys from CMV-posilive donors (D+) were given prophylactic CMV hyperimmune globulin inlravenously al three-week intervals lo six monilis. They also received Lhree months of oral low dose acyclovir as did the remaining 288 patients who did nol receive hyperimmune globulin. There was a low incidence of CMV disease which did not differ between groups (D+R-, 10%: D+R+, 5 .5%, D- R+, 7%: D- R-, 0.8%). The major risk factor was the use of OKT3 to treat rejection. CMV disease was seen in 22% of this group (11 of 50) . compared with only 2% (seven of 311) of those not requiring OKT3. There was only one CMV-related death. but palients with CMV disease had a reduced graft survival rate (62% versus 90%). CMV hyperimmune globulin added lo acyclovir appears to reduce the incidence of CMV disease in high risk renal recipients (D+R-) in the lower risk groups.
Prophylaxis of Cytomegalovirus in Renal Transplant Recipients