Geographic Distribution of Cytomegalovirus Serology in Kidney and Pancreas Transplant Recipients in the United States.

Backgrounds: Cytomegalovirus (CMV) negatively affects transplant outcomes. The current geographic distribution of CMV risk within the US has not been described.

Methods: CMV serostatus of donors and recipients in each US state were collected from the Scientific Registry of Transplant Recipients between April 1, 2015, and March 31, 2019. The objective was to describe rates of CMV recipient seropositivity (R+) and high-risk serostatus (D+/R-) across the US in kidney transplant recipient (KTR) and pancreas transplant recipient (PTR) and explore geographic disparities.

Results: A total of 79 276 KTRs and 4023 PTRs were included. The average KTR R+ rate across states was 59.5% (range 39%-76%); PTR R+ rate was 49.5% but with a broader range (0%-100%). The average KTR D+/R- rate across the US was 19% (range 8.7%-25%); PTR D+/R- rate was notably higher (26.9%, range 0%-50%). KTR seropositivity varied geographically with more R+ recipients in the southern states, Alaska, and Hawaii. D+/R- KTRs also varied by region, with higher rates in the Rocky Mountain Region as well as the Midwest and the northern-most states of the Northeast. Trends found in KTR persisted in PTR.

Conclusions: The distribution of CMV serostatus in the US varies by state and allograft type. These data may be useful in further discussion of national CMV donor-matching strategies.