Ranganathan, K and Worley, S and Michaels, MG and Arrigan, S and Aurora, P and Ballmann, M and Boyer, D and Conrad, C and Eichler, I and Elidemir, O and Goldfarb, S and Mallory, GB and Mogayzel, PJ and Parakininkas, D and Solomon, M and Visner, G and Sweet, SC and Faro, A and nziger-Isakov, L (2009) Cytomegalovirus Immunoglobulin Decreases the Risk of Cytomegalovirus Infection but not Disease After Pediatric Lung Transplantation. Journal of Heart and Lung Transplantation , 28 (10) 1050 - 1056.
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Background: Cytomegalovirus (CMV) has been associated with morbidity, including chronic allograft rejection, in transplant recipients. Data from adult centers suggests that CMV hyperimmune globulin (CMVIG) and ganciclovir together are superior in preventing CMV viremia than ganciclovir alone. Methods: A retrospective review of pediatric lung transplant recipients at 14 sites in North America and Europe was conducted to evaluate the effect of adding cytomegalovirus immunoglobulin (CMVIG) prophylaxis to at least 3 weeks of intravenous ganciclovir therapy in pediatric lung transplant recipients. Data were recorded for the first year after transplantation. Associations between time to CMV and risk factors, including CMVIG use, were assessed by multivariable Cox proportional hazards models. Results: Of 599 patients whose records were reviewed, 329 received at least 3 weeks of ganciclovir, with 62 (19%) receiving CMVIG. CMVIG was administered more frequently with CMV donor-positive/recipient-negative serostatus (p < 0.05). In multivariable models, patients who did not receive CMVIG as part of their prophylaxis were 3 times more likely to develop CMV infection (hazard ratio, 3.4; 95% confidence interval, 1.2-9-5) independent of CMV serostatus. However, CMVIG administration was not associated with decreased risk of episodes of CMV disease. Receipt of CMVIG was not associated with decreased risks of post-transplant morbidities (acute rejection, respiratory viral infection or early bronchiolitis obliterans) or morbidity within the first year after pediatric lung transplantation. Conclusion: The use of CMVIG in addition to antiviral prophylaxis in pediatric lung transplantation requires further evaluation. J Heart Lung Transplant 2009;28:1050-6. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation
|Title:||Cytomegalovirus Immunoglobulin Decreases the Risk of Cytomegalovirus Infection but not Disease After Pediatric Lung Transplantation|
|Additional information:||WoS ID: 000270918000006 JOCT|
|Keywords:||14, Adult, Disease, Heart, Lung, Lung Transplantation, methods, Morbidity, Proportional Hazards Models, RESPIRATORY, REVIEW, Risk, Risk Factors, therapy, transplantation|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health|
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