De Novo Use of Everolimus Reduces Late-Onset Cytomegalovirus Primary Disease Occurring After Antiviral Prophylaxis Discontinuation in Kidney Transplant Recipients.

A. Devresse,¹ V. Avettand-Fenoel,² A. Scemla,³ L. Morin,³ X. Lebreton,³ C. Tinel,³ L. Amrouche,³ L. Lamhaut,⁴ M.-O. Timsit,⁵ J. Zuber,³ C. Legendre,³ D. Anglicheau.³

¹Nephrology Unit, Cliniques Universitaires Saint-Luc, Brussels, Belgium
²Virology Unit, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
³Kidney Transplantation and Intensive Care Unit, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
⁴Anesthesia Unit, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
⁵Urology Unit, Hôpital Necker-Enfants Malades, AP-HP, Paris, France

Meeting: 2017 American Transplant Congress

Abstract number: 73

Keywords: Infection

Session Information

Session Name: Concurrent Session: Novel Immunosuppression Regimens - Tacrolimus Combinations

Session Type: Concurrent Session

Date: Sunday, April 30, 2017

Session Time: 2:30pm-4:00pm

Presentation Time: 3:30pm-3:42pm

Location: E450b

Background: Donor (D)+/recipient (R)- serostatus is critically associated with an higher risk of cytomegalovirus (CMV) infection and disease. Antiviral prophylaxis is conventionally used in such patients, but late-onset CMV infection/disease still occurs after prophylaxis discontinuation.

Method: We retrospectively analyzed data of 215 low immunological risk patients who received kidney transplantation in our center between 2011 and 2016.

Results: Ninety-seven patients received a combination of everolimus (EVL)/reduced doses of calcineurin inhibitors (CNI) (EVL group) de novo, and 118 received a combination of mycophenolic acid (MPA)/standard doses of CNI (MPA group) de novo. All patients received induction by basiliximab, steroids and standardized antiviral prophylaxis depending on their CMV D/R serostatus. D+/R- recipients comprised 17% (n=16) of the EVL group and 19% (n=22) of the MPA group (P=0.722). In the D+/R- subgroup, the 1-year incidence of late-onset CMV primary disease after the withdrawal of prophylaxis was lower than that in the EVL group (6% vs 41%, P=0.025). Kaplan-Meier analysis of 1-year CMV primary disease-free survival in seronegative patients showed significantly better survival in the EVL group (P=0.029, log-rank test). Conclusion: The de novo use of EVL reduces late-onset CMV primary disease after the withdrawal of antiviral prophylaxis in kidney transplantation patients.

CITATION INFORMATION: Devresse A, Avettand-Fenoel V, Scemla A, Morin L, Lebreton X, Tinel C, Amrouche L, Lamhaut L, Timsit M.-O, Zuber J, Legendre C, Anglicheau D. De Novo Use of Everolimus Reduces Late-Onset Cytomegalovirus Primary Disease Occurring After Antiviral Prophylaxis Discontinuation in Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Devresse A, Avettand-Fenoel V, Scemla A, Morin L, Lebreton X, Tinel C, Amrouche L, Lamhaut L, Timsit M-O, Zuber J, Legendre C, Anglicheau D. De Novo Use of Everolimus Reduces Late-Onset Cytomegalovirus Primary Disease Occurring After Antiviral Prophylaxis Discontinuation in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/de-novo-use-of-everolimus-reduces-late-onset-cytomegalovirus-primary-disease-occurring-after-antiviral-prophylaxis-discontinuation-in-kidney-transplant-recipients/. Accessed November 24, 2024.

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