Effect of antiviral chemoprophylaxis on adverse clinical outcomes associated with cytomegalovirus after liver transplantation

Walter C. Hellinger, Hugo Bonatti, Victor I. Machicao, Joseph D. Yao, Lisa M. Brumble, Salvador Alvarez, Stephen D. Weigand, Rolland Dickson, Denise Harnois, James R. Spivey, Wolf H. Stapelfeldt, Christopher B. Hughes, Justin H Nguyen, Jeffery L. Steers

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

OBJECTIVE: To assess the association between cytomegalovirus (CMV) serology of donor and recipient and adverse outcomes after liver transplantation in the era of effective antiviral chemoprophylaxis. PATIENTS AND METHODS: We performed a retrospective cohort study of 193 consecutive patients undergoing their first liver transplantation between February 1998 and July 2000 with targeted and preemptive ganciclovir chemoprophylaxis. Patients were divided into 4 groups by CMV serology of donor and recipient: donor-/recipient-; donor-/recipient+; donor+/recipient+; and donor+/recipient-. Survival to the end points of retransplantation, death, or survival to 1 year after transplantation (whichever occurred first) was assessed. Rates of bacterial, fungal, and CMV infection and of CMV disease were recorded and compared. RESULTS: No significant differences were observed in the rates of retransplantation, death, or survival to 1 year among the 4 groups of patients. Despite significantly higher rates of CMV infection in the donor+ groups, there were no differences in the rates of bacterial or fungal infection or of CMV disease. Rejection occurred least frequently in the donor-/recipient- group. CONCLUSION: The adverse effects of CMV on outcomes after liver transplantation have been diminished in the era of effective antiviral chemoprophylaxis.

Original languageEnglish (US)
Pages (from-to)1029-1033
Number of pages5
JournalMayo Clinic Proceedings
Volume81
Issue number8
DOIs
StatePublished - 2006

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Chemoprevention
Cytomegalovirus
Liver Transplantation
Antiviral Agents
Tissue Donors
Mycoses
Cytomegalovirus Infections
Serology
Bacterial Infections
Ganciclovir
Survival
Cohort Studies
Survival Rate
Retrospective Studies
Transplantation
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hellinger, W. C., Bonatti, H., Machicao, V. I., Yao, J. D., Brumble, L. M., Alvarez, S., ... Steers, J. L. (2006). Effect of antiviral chemoprophylaxis on adverse clinical outcomes associated with cytomegalovirus after liver transplantation. Mayo Clinic Proceedings, 81(8), 1029-1033. https://doi.org/10.4065/81.8.1029

Effect of antiviral chemoprophylaxis on adverse clinical outcomes associated with cytomegalovirus after liver transplantation. / Hellinger, Walter C.; Bonatti, Hugo; Machicao, Victor I.; Yao, Joseph D.; Brumble, Lisa M.; Alvarez, Salvador; Weigand, Stephen D.; Dickson, Rolland; Harnois, Denise; Spivey, James R.; Stapelfeldt, Wolf H.; Hughes, Christopher B.; Nguyen, Justin H; Steers, Jeffery L.

In: Mayo Clinic Proceedings, Vol. 81, No. 8, 2006, p. 1029-1033.

Research output: Contribution to journalArticle

Hellinger, WC, Bonatti, H, Machicao, VI, Yao, JD, Brumble, LM, Alvarez, S, Weigand, SD, Dickson, R, Harnois, D, Spivey, JR, Stapelfeldt, WH, Hughes, CB, Nguyen, JH & Steers, JL 2006, 'Effect of antiviral chemoprophylaxis on adverse clinical outcomes associated with cytomegalovirus after liver transplantation', Mayo Clinic Proceedings, vol. 81, no. 8, pp. 1029-1033. https://doi.org/10.4065/81.8.1029
Hellinger, Walter C. ; Bonatti, Hugo ; Machicao, Victor I. ; Yao, Joseph D. ; Brumble, Lisa M. ; Alvarez, Salvador ; Weigand, Stephen D. ; Dickson, Rolland ; Harnois, Denise ; Spivey, James R. ; Stapelfeldt, Wolf H. ; Hughes, Christopher B. ; Nguyen, Justin H ; Steers, Jeffery L. / Effect of antiviral chemoprophylaxis on adverse clinical outcomes associated with cytomegalovirus after liver transplantation. In: Mayo Clinic Proceedings. 2006 ; Vol. 81, No. 8. pp. 1029-1033.
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abstract = "OBJECTIVE: To assess the association between cytomegalovirus (CMV) serology of donor and recipient and adverse outcomes after liver transplantation in the era of effective antiviral chemoprophylaxis. PATIENTS AND METHODS: We performed a retrospective cohort study of 193 consecutive patients undergoing their first liver transplantation between February 1998 and July 2000 with targeted and preemptive ganciclovir chemoprophylaxis. Patients were divided into 4 groups by CMV serology of donor and recipient: donor-/recipient-; donor-/recipient+; donor+/recipient+; and donor+/recipient-. Survival to the end points of retransplantation, death, or survival to 1 year after transplantation (whichever occurred first) was assessed. Rates of bacterial, fungal, and CMV infection and of CMV disease were recorded and compared. RESULTS: No significant differences were observed in the rates of retransplantation, death, or survival to 1 year among the 4 groups of patients. Despite significantly higher rates of CMV infection in the donor+ groups, there were no differences in the rates of bacterial or fungal infection or of CMV disease. Rejection occurred least frequently in the donor-/recipient- group. CONCLUSION: The adverse effects of CMV on outcomes after liver transplantation have been diminished in the era of effective antiviral chemoprophylaxis.",
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AU - Bonatti, Hugo

AU - Machicao, Victor I.

AU - Yao, Joseph D.

AU - Brumble, Lisa M.

AU - Alvarez, Salvador

AU - Weigand, Stephen D.

AU - Dickson, Rolland

AU - Harnois, Denise

AU - Spivey, James R.

AU - Stapelfeldt, Wolf H.

AU - Hughes, Christopher B.

AU - Nguyen, Justin H

AU - Steers, Jeffery L.

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N2 - OBJECTIVE: To assess the association between cytomegalovirus (CMV) serology of donor and recipient and adverse outcomes after liver transplantation in the era of effective antiviral chemoprophylaxis. PATIENTS AND METHODS: We performed a retrospective cohort study of 193 consecutive patients undergoing their first liver transplantation between February 1998 and July 2000 with targeted and preemptive ganciclovir chemoprophylaxis. Patients were divided into 4 groups by CMV serology of donor and recipient: donor-/recipient-; donor-/recipient+; donor+/recipient+; and donor+/recipient-. Survival to the end points of retransplantation, death, or survival to 1 year after transplantation (whichever occurred first) was assessed. Rates of bacterial, fungal, and CMV infection and of CMV disease were recorded and compared. RESULTS: No significant differences were observed in the rates of retransplantation, death, or survival to 1 year among the 4 groups of patients. Despite significantly higher rates of CMV infection in the donor+ groups, there were no differences in the rates of bacterial or fungal infection or of CMV disease. Rejection occurred least frequently in the donor-/recipient- group. CONCLUSION: The adverse effects of CMV on outcomes after liver transplantation have been diminished in the era of effective antiviral chemoprophylaxis.

AB - OBJECTIVE: To assess the association between cytomegalovirus (CMV) serology of donor and recipient and adverse outcomes after liver transplantation in the era of effective antiviral chemoprophylaxis. PATIENTS AND METHODS: We performed a retrospective cohort study of 193 consecutive patients undergoing their first liver transplantation between February 1998 and July 2000 with targeted and preemptive ganciclovir chemoprophylaxis. Patients were divided into 4 groups by CMV serology of donor and recipient: donor-/recipient-; donor-/recipient+; donor+/recipient+; and donor+/recipient-. Survival to the end points of retransplantation, death, or survival to 1 year after transplantation (whichever occurred first) was assessed. Rates of bacterial, fungal, and CMV infection and of CMV disease were recorded and compared. RESULTS: No significant differences were observed in the rates of retransplantation, death, or survival to 1 year among the 4 groups of patients. Despite significantly higher rates of CMV infection in the donor+ groups, there were no differences in the rates of bacterial or fungal infection or of CMV disease. Rejection occurred least frequently in the donor-/recipient- group. CONCLUSION: The adverse effects of CMV on outcomes after liver transplantation have been diminished in the era of effective antiviral chemoprophylaxis.

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