Delay of CMV infection in high-risk CMV mismatch lung transplant recipients due to prophylaxis with oral ganciclovir.
In: Clinical Transplantation, Jg. 18 (2004-04-01), Heft 2, S. 179-185
Online
academicJournal
Zugriff:
Palmer SM, Grinnan DC, Reams BD, Steele MP, Messier RH, Davis RD. Delay of CMV infection in high-risk CMV mismatch lung transplant recipients due to prophylaxis with oral ganciclovir. Clin Transplant 2004: 18: 179–185. © Blackwell Munksgaard, 2004 Cytomegalovirus (CMV) is a common opportunistic infection in lung transplant recipients. Despite the use of early post-operative intravenous ganciclovir, most high-risk patients develop CMV infection. We conducted this retrospective study to determine the efficacy of extended CMV prophylaxis with oral ganciclovir in high-risk, donor-positive–recipient-negative, lung recipients. All patients initially received 3 months of intravenous ganciclovir and CMV hyperimmune globulin. Clinical outcomes in all CMV mismatch patients undergoing lung transplant surviving at least 3 months were included (n = 42). Since 1998, 14 patients received no oral ganciclovir prophylaxis (group 1) and 28 patients received indefinite oral ganciclovir after completion of intravenous therapy (group 2). In those patients receiving oral ganciclovir, the prevalence of post-transplant CMV infection was significantly reduced over the first 180 d post-transplant (50% in group 1 vs. 4% in group 2; p < 0.001). Although some CMV events were observed with additional follow-up in group 2, there remained a significantly greater freedom from CMV infection by Kaplan–Meier analysis in group 2 as compared with group 1, with over 30 months follow-up time in each group (log-rank, p = 0.02). A moderate rate of drug discontinuation was observed in group 2, and no severe drug-related events occurred. In high-risk lung transplant recipients, CMV prophylaxis with intravenous ganciclovir, followed by indefinite oral ganciclovir, significantly delays and reduces post-transplant CMV infections. A larger prospective randomized study is needed to confirm the benefits of oral ganciclovir on CMV prevention. [ABSTRACT FROM AUTHOR]
Copyright of Clinical Transplantation is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Delay of CMV infection in high-risk CMV mismatch lung transplant recipients due to prophylaxis with oral ganciclovir.
|
---|---|
Autor/in / Beteiligte Person: | Palmer, Scott M. ; Grinnan, Dan C. ; Reams, B Diane ; Steele, Mark P. ; Messier, Robert H ; Davis, R Duane |
Link: | |
Zeitschrift: | Clinical Transplantation, Jg. 18 (2004-04-01), Heft 2, S. 179-185 |
Veröffentlichung: | 2004 |
Medientyp: | academicJournal |
ISSN: | 0902-0063 (print) |
DOI: | 10.1046/j.1399-0012.2003.00152.x |
Schlagwort: |
|
Sonstiges: |
|