Abstract
The patient was a 54-year-old man, who had a long history of type 1 diabetes mellitus for 33 years. Simultaneous pancreas-kidney transplantation was performed from a cadaveric donor in 2006. Prophylaxis with intravenous ganciclovir was done for 8 days posttransplantation due to CMV mismatch combination (seropositive donor to seronegative recipient). On postoperative day 27, diarrhea occurred and he was CMV antigenemia-positive. After resuming intravenous GCV, diarrhea disappeared and data of CMV antigenemia went into remission. Thus, he was discharged on postoperative day 55. However, he was rehospitalized because fever and explosive diarrhea on the fifth day after discharge. Colonoscopy showed multiple scattered reddish spots on the rectum from the cecum. Pathological examination of the reddish mucosa immunohistochemically revealed CMV-positive cells, so the diagnosis of CMV colitis was confirmed. The risk of CMV disease is the highest among CMV-seronegative recipients of a graft from seropositive donors on pancreas transplantation. Strong prophylaxis for CMV and careful monitoring were required.
