Solid organ transplantation: Results and implications of acyclovir use in liver transplants

C. V. Paya, E. Marin, M. Keating, Rolland Dickson, M. Porayko, R. Wiesner

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

CMV infection is a major cause of morbidity and mortality following liver transplantation (LT). A prospective study of 218 LT recipients showed that 55% of patients developed CMV infection during the 1st year post-transplantation. Symptomatic CMV infection developed in 25% of all patients, being a major cause of death (21% of all deaths). Of 62 episodes of documented organ invasion, liver was the major site (38 episodes), followed by lung (20), gastrointestinal (4), and retina (4). The main patient group at risk (according to CMV serology of the recipient [(R)/donor(D)]) was the R-/D+: 77% of patients developed CMV infection, all of them with symptoms. The lowest group at risk was the R-/D-: 13% of patients developed CMV infection, half of whom developed symptoms. Time-dependent multivariate statistical analysis of risk factors indicated that the R-/D+ group was the main risk factor for CMV infection (P < .02) and symptomatic infection (P < .0001). To decrease the incidence and severity of CMV infection following LT, a randomized study is ongoing to evaluate the efficacy of ganciclovir (5 mg/kg/IV/q 12 hours for the first 14 days post-LT) followed by acyclovir (800 mg/po/qid for 14 weeks) GCV + ACV (group I), versus acyclovir (same dose for 16 weeks, starting immediately post-LT) ACV (group II). These treatment groups are compared to matched historical controls (C). Preliminary analysis of 83 LT recipients indicates that in group I the median date for the first evidence of CMV infection is delayed (82 days) as compared to group II and C (41 and 33 days, respectively) (P = .004). Group I shows a lower incidence of CMV infection (25%) than groups II and C (45 and 63%, respectively), (P = .004). No significant difference was found between the three groups in the incidence of symptomatic infection.

Original languageEnglish (US)
Pages (from-to)123-127
Number of pages5
JournalJournal of Medical Virology
Volume41
Issue numberSUPPL. 1
StatePublished - 1993

Fingerprint

Acyclovir
Organ Transplantation
Transplants
Liver
Liver Transplantation
Infection
Incidence
Ganciclovir
Serology
Retina
Cause of Death
Multivariate Analysis
Transplantation
Tissue Donors
Prospective Studies
Morbidity

Keywords

  • ganciclovir
  • risk factors
  • serology

ASJC Scopus subject areas

  • Virology

Cite this

Paya, C. V., Marin, E., Keating, M., Dickson, R., Porayko, M., & Wiesner, R. (1993). Solid organ transplantation: Results and implications of acyclovir use in liver transplants. Journal of Medical Virology, 41(SUPPL. 1), 123-127.

Solid organ transplantation : Results and implications of acyclovir use in liver transplants. / Paya, C. V.; Marin, E.; Keating, M.; Dickson, Rolland; Porayko, M.; Wiesner, R.

In: Journal of Medical Virology, Vol. 41, No. SUPPL. 1, 1993, p. 123-127.

Research output: Contribution to journalArticle

Paya, CV, Marin, E, Keating, M, Dickson, R, Porayko, M & Wiesner, R 1993, 'Solid organ transplantation: Results and implications of acyclovir use in liver transplants', Journal of Medical Virology, vol. 41, no. SUPPL. 1, pp. 123-127.
Paya, C. V. ; Marin, E. ; Keating, M. ; Dickson, Rolland ; Porayko, M. ; Wiesner, R. / Solid organ transplantation : Results and implications of acyclovir use in liver transplants. In: Journal of Medical Virology. 1993 ; Vol. 41, No. SUPPL. 1. pp. 123-127.
@article{0dca99e3043547bbbc52325c171f7899,
title = "Solid organ transplantation: Results and implications of acyclovir use in liver transplants",
abstract = "CMV infection is a major cause of morbidity and mortality following liver transplantation (LT). A prospective study of 218 LT recipients showed that 55{\%} of patients developed CMV infection during the 1st year post-transplantation. Symptomatic CMV infection developed in 25{\%} of all patients, being a major cause of death (21{\%} of all deaths). Of 62 episodes of documented organ invasion, liver was the major site (38 episodes), followed by lung (20), gastrointestinal (4), and retina (4). The main patient group at risk (according to CMV serology of the recipient [(R)/donor(D)]) was the R-/D+: 77{\%} of patients developed CMV infection, all of them with symptoms. The lowest group at risk was the R-/D-: 13{\%} of patients developed CMV infection, half of whom developed symptoms. Time-dependent multivariate statistical analysis of risk factors indicated that the R-/D+ group was the main risk factor for CMV infection (P < .02) and symptomatic infection (P < .0001). To decrease the incidence and severity of CMV infection following LT, a randomized study is ongoing to evaluate the efficacy of ganciclovir (5 mg/kg/IV/q 12 hours for the first 14 days post-LT) followed by acyclovir (800 mg/po/qid for 14 weeks) GCV + ACV (group I), versus acyclovir (same dose for 16 weeks, starting immediately post-LT) ACV (group II). These treatment groups are compared to matched historical controls (C). Preliminary analysis of 83 LT recipients indicates that in group I the median date for the first evidence of CMV infection is delayed (82 days) as compared to group II and C (41 and 33 days, respectively) (P = .004). Group I shows a lower incidence of CMV infection (25{\%}) than groups II and C (45 and 63{\%}, respectively), (P = .004). No significant difference was found between the three groups in the incidence of symptomatic infection.",
keywords = "ganciclovir, risk factors, serology",
author = "Paya, {C. V.} and E. Marin and M. Keating and Rolland Dickson and M. Porayko and R. Wiesner",
year = "1993",
language = "English (US)",
volume = "41",
pages = "123--127",
journal = "Journal of Medical Virology",
issn = "0146-6615",
publisher = "Wiley-Liss Inc.",
number = "SUPPL. 1",

}

TY - JOUR

T1 - Solid organ transplantation

T2 - Results and implications of acyclovir use in liver transplants

AU - Paya, C. V.

AU - Marin, E.

AU - Keating, M.

AU - Dickson, Rolland

AU - Porayko, M.

AU - Wiesner, R.

PY - 1993

Y1 - 1993

N2 - CMV infection is a major cause of morbidity and mortality following liver transplantation (LT). A prospective study of 218 LT recipients showed that 55% of patients developed CMV infection during the 1st year post-transplantation. Symptomatic CMV infection developed in 25% of all patients, being a major cause of death (21% of all deaths). Of 62 episodes of documented organ invasion, liver was the major site (38 episodes), followed by lung (20), gastrointestinal (4), and retina (4). The main patient group at risk (according to CMV serology of the recipient [(R)/donor(D)]) was the R-/D+: 77% of patients developed CMV infection, all of them with symptoms. The lowest group at risk was the R-/D-: 13% of patients developed CMV infection, half of whom developed symptoms. Time-dependent multivariate statistical analysis of risk factors indicated that the R-/D+ group was the main risk factor for CMV infection (P < .02) and symptomatic infection (P < .0001). To decrease the incidence and severity of CMV infection following LT, a randomized study is ongoing to evaluate the efficacy of ganciclovir (5 mg/kg/IV/q 12 hours for the first 14 days post-LT) followed by acyclovir (800 mg/po/qid for 14 weeks) GCV + ACV (group I), versus acyclovir (same dose for 16 weeks, starting immediately post-LT) ACV (group II). These treatment groups are compared to matched historical controls (C). Preliminary analysis of 83 LT recipients indicates that in group I the median date for the first evidence of CMV infection is delayed (82 days) as compared to group II and C (41 and 33 days, respectively) (P = .004). Group I shows a lower incidence of CMV infection (25%) than groups II and C (45 and 63%, respectively), (P = .004). No significant difference was found between the three groups in the incidence of symptomatic infection.

AB - CMV infection is a major cause of morbidity and mortality following liver transplantation (LT). A prospective study of 218 LT recipients showed that 55% of patients developed CMV infection during the 1st year post-transplantation. Symptomatic CMV infection developed in 25% of all patients, being a major cause of death (21% of all deaths). Of 62 episodes of documented organ invasion, liver was the major site (38 episodes), followed by lung (20), gastrointestinal (4), and retina (4). The main patient group at risk (according to CMV serology of the recipient [(R)/donor(D)]) was the R-/D+: 77% of patients developed CMV infection, all of them with symptoms. The lowest group at risk was the R-/D-: 13% of patients developed CMV infection, half of whom developed symptoms. Time-dependent multivariate statistical analysis of risk factors indicated that the R-/D+ group was the main risk factor for CMV infection (P < .02) and symptomatic infection (P < .0001). To decrease the incidence and severity of CMV infection following LT, a randomized study is ongoing to evaluate the efficacy of ganciclovir (5 mg/kg/IV/q 12 hours for the first 14 days post-LT) followed by acyclovir (800 mg/po/qid for 14 weeks) GCV + ACV (group I), versus acyclovir (same dose for 16 weeks, starting immediately post-LT) ACV (group II). These treatment groups are compared to matched historical controls (C). Preliminary analysis of 83 LT recipients indicates that in group I the median date for the first evidence of CMV infection is delayed (82 days) as compared to group II and C (41 and 33 days, respectively) (P = .004). Group I shows a lower incidence of CMV infection (25%) than groups II and C (45 and 63%, respectively), (P = .004). No significant difference was found between the three groups in the incidence of symptomatic infection.

KW - ganciclovir

KW - risk factors

KW - serology

UR - http://www.scopus.com/inward/record.url?scp=0027736473&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027736473&partnerID=8YFLogxK

M3 - Article

C2 - 8245877

AN - SCOPUS:0027736473

VL - 41

SP - 123

EP - 127

JO - Journal of Medical Virology

JF - Journal of Medical Virology

SN - 0146-6615

IS - SUPPL. 1

ER -