Evaluation of Cytomegalovirus Prophylaxis Regimens in Intestinal Transplant Recipients: A Single Center Experience.
1Department of Pharmaceutical and Nutrition Care, Nebraska Medicine, Omaha, NE
2College of Pharmacy: Department of Pharmacy Practice, University Of Nebraska Medical Center, Omaha, NE
Meeting: 2017 American Transplant Congress
Abstract number: 466
Keywords: Cytomeglovirus, Infection, Intestinal transplantation, Multivisceral transplantation
Session Information
Session Name: Concurrent Session: Small Bowel: All Topics
Session Type: Concurrent Session
Date: Tuesday, May 2, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:42pm-3:54pm
Location: E271b
Purpose: To evaluate the incidence of cytomegalovirus (CMV) infection in intestinal transplant recipients after a change in an antiviral regimen.
Methods: This was a retrospective review including intestinal transplant recipients at an academic medical center from January 1st 2004 through June 30, 2016. Patients were included if they received an intestinal (isolated or multivisceral) transplant, and received viral prophylaxis within the first 30 days post-transplant. Prior to 2011, antiviral therapy (ganciclovir, valganciclovir, or acyclovir and cytomegalovirus immune globulin) was given at standard doses for 1 year post-transplant based on donor and recipient serostatus (group 1). After 2011, antiviral therapy doses were reduced and duration was shortened to six months for high risk (CMV D+/R-) and three months for moderate (CMV R+) and low (CMV D-/R-) risk patients (group2). The primary outcome was the incidence of CMV infection. Secondary outcomes included tissue-invasive CMV disease, CMV resistance, allograft rejection, graft loss, adverse effects from antiviral prophylaxis, and mortality.
Results: Sixty-two transplant recipients were included in this analysis (85% pediatric and 15% adult). No differences were detected in the incidence of CMV infection between groups 1 and 2 (23% vs 16%, P=0.75). Of documented CMV infections, 75% occurred while patients were on viral prophylaxis, with no difference detected between groups 1 and 2 (86% vs 60%, P=0.40). No differences were detected in CMV tissue-invasive disease (10% vs 0%, P=0.24); CMV resistance (6% vs 13%, P=0.67); allograft rejection (29% vs 32%, P=1.00); graft loss (6.5% vs 0%, P=0.49); or adverse effects (65% vs 52%, P=0.30) between groups 1 and 2 respectively. A total of 13 (42%) patients died within the study time frame. Three patients (10%) in group 1 and 2 patients (6%) in group 2 died due to CMV infection.
Conclusion: Intestinal transplant recipients receiving a decreased dose and duration of CMV antiviral prophylaxis do not appear to be at increased risk of CMV infection or CMV-related complications compared to those receiving higher doses for longer durations after transplant.
CITATION INFORMATION: Eley M, Keck M, Collier D, Vacha M. Evaluation of Cytomegalovirus Prophylaxis Regimens in Intestinal Transplant Recipients: A Single Center Experience. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Eley M, Keck M, Collier D, Vacha M. Evaluation of Cytomegalovirus Prophylaxis Regimens in Intestinal Transplant Recipients: A Single Center Experience. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/evaluation-of-cytomegalovirus-prophylaxis-regimens-in-intestinal-transplant-recipients-a-single-center-experience/. Accessed May 17, 2025.« Back to 2017 American Transplant Congress