【Background】 It has been reported that everolimus administration reduces the incidence of cytomegalovirus infection; however, the clinical outcomes in CMV-seronegative recipients with EVR-based regimens as immunosuppressive induction therapy are unclear.

【Methods】 Forty-one CMV-seronegative patients who underwent living-related kidney transplant (KT) from CMV-seropositive donors were enrolled. Among the forty-one, twenty-five recipients were treated with EVR in addition to tacrolimus (TAC), mycophenolate mofetil (MMF), and three doses of perioperative methylprednisolone (EVR group). The historical control group was comprised of 16 recipients who received TAC/MMF with or without methylprednisolone (control group). Basiliximab was used as an induction mAb in each group. The incidence within one year, time of primary CMV infection, incidence of CMV disease that required ganciclovir, and rate of CMV antibody acquisition were analyzed retrospectively.

【Results】 There were no statistical differences between the two groups in age at transplant, sex, high-risk immunosuppression, incidence of acute rejection within one year, or prophylactic administration period. The incidence of primary CMV infection within one year was 68% in both groups, while the time of occurrence after kidney transplantation was significantly later in the EVR group (EVR: 7.8 months, control, 6 months; p=0.04). Additionally, there were significantly fewer cases of CMV disease requiring GCV with EVR. (EVR: 52%, Control: 90%, p=0.04). There was also no statistically significant difference in the acquisition rate of CMV-antibody. (EVR: 80%, Control: 87%)

【Conclusion】 EVR as an immunosuppressive induction therapy could delay primary CMV infection after discontinuation of prophylactic VGCV, and suppress the development of CMV disease.