Adjudication committee
- First opponent: Dr. Margrét Birna Andrésdottir, Landspitali University Hospital, Iceland
- Second opponent: Professor Jan Kristian Damås, NTNU: Norwegian University of Science and Technology,
- Third member and chair of the evaluation committee: Associate Professor Dag Henrik Reikvam, University of Oslo
Chair of the Defence
Professor Susanne Dudman, University of Oslo
Principal Supervisor
Senior Physician Jon Arne Birkeland, Oslo University Hospital
Summary
Kidney transplant recipients are in need of life-long immunosuppression to prevent rejection of the kidney graft. Unfortunately, immunosuppressive drugs elevate the risk of infections such as CMV infection and COVID-19.
The aim of the thesis Viral infections in Norwegian kidney transplant recipients: Impact of COVID-19 and CMV was to explore how CMV and COVID-19 have affected Norwegian kidney transplant recipients.
In the first study, we investigated if kidney transplant recipients everyday-life behavior was altered due to the COVID-19 pandemic. Kidney transplant recipients, and a control group randomly selected from the general population, answered questionnaires regarding everyday-life behavior. Kidney transplant recipients reported to be more worried about COVID-19 than the control group. They also reported strict adherence to nationally advised preventive measures, and behaved more carefully in their everyday-life than the control group.
Paper two and three were historic prospective cohort studies. In paper two, we examined how prophylactic therapy, and therapy based on acute infection (preemptive therapy), affected long-term outcomes in CMV high-risk kidney transplant recipients. There were no difference in long-term patient- and graft survival among CMV high-risk kidney transplant recipients receiving prophylaxis compared to those who received preemptive management.
In the third study we found that CMV-IGRA does not predict later active CMV infection among kidney transplant recipients with intermediate risk of such infection. However, among CMV high-risk kidney transplant recipients, a retained negative CMV-IGRA one year after transplantation, is associated with an increased risk of later developing active CMV infection.
We conclude that viral infections remain a major burden after kidney transplantation and that there is a need for a more personalized approach in the handling of viral infections among kidney transplant recipients.
