E Beam1, T Lesnick2, W Kremers2,3, C C Kennedy3,4, R R Razonable1,4. 1. Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA. 2. Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA. 3. The William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic College of Medicine, Rochester, MN, USA. 4. Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
Abstract
BACKGROUND: The duration of anticytomegalovirus (CMV) prophylaxis after lung transplantation (LT) varies among transplant centers. METHODS: A retrospective review of CMV donor-seropositive/recipient-seronegative (D+/R-) and CMV recipient-seropositive (R+) LT patients between January 2005 and September 2012 was performed. Starting January 2007, valganciclovir prophylaxis was given for at least 12 months (often lifelong) for CMV D+/R- and extended from three to six months for R+ LT patients. Risks of CMV infection and CMV disease, and mortality after LT, were assessed. RESULTS: A total of 88 LT patients were studied, including 32 CMV D+/R-, and 56 R+ patients. During the follow-up period, 11 (12.5%) patients had asymptomatic CMV infection, and nine (10.3%) developed CMV disease. CMV disease (HR, 4.189; 95% CI: 1.672-10.495; p = 0.002) and CMV infection and disease (HR, 3.775; 95% CI: 1.729-8.240; p = 0.001) were significant risk factors for mortality. Overall, no significant difference was observed in rates of CMV infection or disease among LT recipients who received shorter vs. extended CMV prophylaxis. CONCLUSIONS: Despite extended prophylaxis, LT patients remain at risk of CMV infection and disease. CMV remains associated with increased mortality after transplantation.
BACKGROUND: The duration of anticytomegalovirus (CMV) prophylaxis after lung transplantation (LT) varies among transplant centers. METHODS: A retrospective review of CMV donor-seropositive/recipient-seronegative (D+/R-) and CMV recipient-seropositive (R+) LT patients between January 2005 and September 2012 was performed. Starting January 2007, valganciclovir prophylaxis was given for at least 12 months (often lifelong) for CMV D+/R- and extended from three to six months for R+ LT patients. Risks of CMV infection and CMV disease, and mortality after LT, were assessed. RESULTS: A total of 88 LT patients were studied, including 32 CMV D+/R-, and 56 R+ patients. During the follow-up period, 11 (12.5%) patients had asymptomatic CMV infection, and nine (10.3%) developed CMV disease. CMV disease (HR, 4.189; 95% CI: 1.672-10.495; p = 0.002) and CMV infection and disease (HR, 3.775; 95% CI: 1.729-8.240; p = 0.001) were significant risk factors for mortality. Overall, no significant difference was observed in rates of CMV infection or disease among LT recipients who received shorter vs. extended CMV prophylaxis. CONCLUSIONS: Despite extended prophylaxis, LT patients remain at risk of CMV infection and disease. CMV remains associated with increased mortality after transplantation.
Authors: Jennifer L Saullo; Arthur W Baker; Laurie D Snyder; John M Reynolds; Lorenzo Zaffiri; Emily M Eichenberger; Alana Ferrari; Julie M Steinbrink; Eileen K Maziarz; Melissa Bacchus; Holly Berry; Stylianos A Kakoullis; Cameron R Wolfe Journal: J Heart Lung Transplant Date: 2021-12-22 Impact factor: 13.569
Authors: Robin K Avery; Sophie Alain; Barbara D Alexander; Emily A Blumberg; Roy F Chemaly; Catherine Cordonnier; Rafael F Duarte; Diana F Florescu; Nassim Kamar; Deepali Kumar; Johan Maertens; Francisco M Marty; Genovefa A Papanicolaou; Fernanda P Silveira; Oliver Witzke; Jingyang Wu; Aimee K Sundberg; Martha Fournier Journal: Clin Infect Dis Date: 2022-09-10 Impact factor: 20.999
Authors: I P Lodding; C da Cunha Bang; S S Sørensen; F Gustafsson; M Iversen; N Kirkby; M Perch; A Rasmussen; H Sengeløv; A Mocroft; J D Lundgren Journal: Open Forum Infect Dis Date: 2018-04-17 Impact factor: 3.835