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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 270-278 |
| Number of pages | 9 |
| Journal | Clinical Transplantation |
| Volume | 30 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2016 |
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Keywords
- Cytomegalovirus
- Extended prophylaxis
- Lung transplant
ASJC Scopus subject areas
- Transplantation
Cite this
Cytomegalovirus disease is associated with higher all-cause mortality after lung transplantation despite extended antiviral prophylaxis. / Beam, E.; Lesnick, T.; Kremers, Walter K; Kennedy, Cassie; Razonable, Raymund R.
In: Clinical Transplantation, Vol. 30, No. 3, 01.03.2016, p. 270-278.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cytomegalovirus disease is associated with higher all-cause mortality after lung transplantation despite extended antiviral prophylaxis
AU - Beam, E.
AU - Lesnick, T.
AU - Kremers, Walter K
AU - Kennedy, Cassie
AU - Razonable, Raymund R
PY - 2016/3/1
Y1 - 2016/3/1
N2 - 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.
AB - 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.
KW - Cytomegalovirus
KW - Extended prophylaxis
KW - Lung transplant
UR - http://www.scopus.com/inward/record.url?scp=84959313086&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959313086&partnerID=8YFLogxK
U2 - 10.1111/ctr.12686
DO - 10.1111/ctr.12686
M3 - Article
C2 - 26701733
AN - SCOPUS:84959313086
VL - 30
SP - 270
EP - 278
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 3
ER -