Despite aggressive prophylaxis with antivirals, CMV infection remains a major complication of immunosuppression in renal transplantation with remarkable health and economic impacts. The incidence of new and recurrent CMV disease in adult renal transplant recipients at a single tertiary care hospital were studied, and multivariable analyses conducted to identify major predictors for CMV disease in the current immunosuppression era. Patients transplanted between January 1, 1999 and December 31, 2002 were included and followed prospectively until December 31, 2006. The primary end point was development of CMV disease and the incidence was 14.6% (95% Cl, 11.7-18%). None had recurrent CMV disease. Using multivariable analysis, factors associated with increased risk of developing CMV disease were CMV sero-status and positive B- cell cross match at time of transplantation. Patients with a positive B-cell crossmatch had a 3 times greater associated risk for developing CMV disease than those with a negative cross-match (OR = 3.23, 95% Confidence Interval, 1.16 - 9.0, p = 0.025). This association has not been previously reported and should be considered when identifying risks and complications with patients
