Date: Tuesday, June 14, 2016
Session Name: Poster Session D: Liver: Immunosuppression and Rejection
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background/purpose Cytomegalovirus (CMV) infection remains a challenge following liver transplantation. Preemptive treatment is an effective strategy for CMV infection. This report shares the ten years' experience at CGMH Linko about short-term preemptive treatment of CMV infection for patients after liver transplantation.
Methods Clinical records of preemptive treatment for CMV infection in patients who underwent liver transplantation were collected. CMV antigenemia (pp65) was monitored weekly during hospital stay and subsequently on follow up whenever indicated clinically. Antiviral treatment was administered based on positive antigenemia ([1 positive cell per 500,000 leukocytes) and discontinued
when antigenemia became negative.
Results CMV infection was diagnosed in 205 (40.8%) of 502 liver transplantation patients. Most patients (98.8%) were seropositive for CMV before transplantation. Patients with graft from male donor (p=0.014) and higher MELD score (p=0.048) got higher incidence of CMV infection after liver transplantation. CMV infection was first diagnosed at a median time of 21 days (interquartile range [IQR] 13–29) after transplantation. Forty-five (21.9%) patients developed repeated infections.
Only two of 205 patients (0.9%) were suspected to have invasive disease. The median (IQR) duration of antiviral treatment was 7 (7–14) days. Of these patients with CMV infection, 52 (25.3%) patients developed acute rejection peri-anti-CMV treatment and 133 (64.9%) developed other infectious complications. The patients with CMV infection had longer hospital stay (p=0.026) in compare to patients without infection, but the 1-, 3-, 6-, and overall mortality had no difference.
Conclusion Preemptive treatment is an effective way to halt the progression of asymptomatic CMV infection. A brief course of antiviral treatment is enough for seropositive patients with CMV infection after liver transplantation.
CITATION INFORMATION: Wu T.-J, Wang Y.-C, Cheng C.-H, Wu T.-H, Soong R.-S, Lee C.-F, Chou H.-S, Chan K.-M, Lee W.-C. Experience of Short-Term Preemptive Treatment for Cytomegalovirus Infection in Seropositive Patients After Liver Transplantation – Ten Years Result of a Single Institution. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Wu T-J, Wang Y-C, Cheng C-H, Wu T-H, Soong R-S, Lee C-F, Chou H-S, Chan K-M, Lee W-C. Experience of Short-Term Preemptive Treatment for Cytomegalovirus Infection in Seropositive Patients After Liver Transplantation – Ten Years Result of a Single Institution. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/experience-of-short-term-preemptive-treatment-for-cytomegalovirus-infection-in-seropositive-patients-after-liver-transplantation-ten-years-result-of-a-single-institution/. Accessed June 7, 2020.
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