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    Por favor, use este identificador para citar o enlazar este ítem:https://uvadoc.uva.es/handle/10324/50778

    Título
    Cytomegalovirus prevention strategies in seropositive kidney transplant recipients: an insight into current clinical practice
    Autor
    Fernandez Ruiz, Mario
    Arias Rodriguez, Manuel
    Campistol Plana, Josep María
    Navarro Ortega, David
    Gómez Huertas, Ernesto
    Gómez Márquez, Gonzalo
    Díaz Gómez, Juan Manuel
    Hernández Marrero, Domingo
    Bernal Blanco, Gabriel
    Cofán Pujol, Frederic
    Jimeno García, Luisa
    Franco Esteve, Antonio
    Gonzalez Monte, Esther
    Moreso Mateos, Francesc
    Gómez Alamillo, Carlos
    Mendiluce Herrero, AliciaAutoridad UVA
    Luna Huerta, Enrique
    Aguado García, José María
    Año del Documento
    2015
    Editorial
    European Society for Organ Transplantation (ESOT)
    Wiley
    Descripción
    Producción Científica
    Documento Fuente
    Transplant International, 2015, vol. 28, n. 9, p. 1042-1054
    Resumen
    There is notable heterogeneity in the implementation of cytomegalovirus (CMV) prevention practices among CMV-seropositive (R+) kidney transplant (KT) recipients. In this prospective observational study, we included 387 CMV R+ KT recipients from 25 Spanish centers. Prevention strategies (antiviral prophylaxis or preemptive therapy) were applied according to institutional protocols at each site. The impact on the 12-month incidence of CMV disease was assessed by Cox regression. Asymptomatic CMV infection, acute rejection, graft function, non-CMV infection, graft loss, and all-cause mortality were also analyzed (secondary outcomes). Models were adjusted for a propensity score (PS) analysis for receiving antiviral prophylaxis. Overall, 190 patients (49.1%) received preemptive therapy, 185 (47.8%) antiviral prophylaxis, and 12 (3.1%) no specific intervention. Twelve-month cumulative incidences of CMV disease and asymptomatic infection were 3.6% and 39.3%, respectively. Patients on prophylaxis had lower incidence of CMV disease [PS-adjusted HR (aHR): 0.10; 95% confidence interval (CI): 0.01–0.79] and asymptomatic infection (aHR: 0.46; 95% CI: 0.29–0.72) than those managed preemptively, with no significant differences according to the duration of prophylaxis. All cases of CMV disease in the prophylaxis group occurred after prophylaxis discontinuation. There were no differences in any of the secondary outcomes. In conclusion, antiviral prophylaxis was associated with a lower occurrence of CMV disease in CMV R+ KT recipients, although such benefit should be balanced with the risk of late-onset disease.
    Materias (normalizadas)
    Riñones - Trasplante
    SIDA (Enfermedad)
    Materias Unesco
    3205.06 Nefrología
    ISSN
    0934-0874
    Revisión por pares
    SI
    DOI
    10.1111/tri.12586
    Version del Editor
    https://onlinelibrary.wiley.com/doi/10.1111/tri.12586
    Propietario de los Derechos
    © 2015 European Society for Organ Transplantation
    Idioma
    eng
    URI
    https://uvadoc.uva.es/handle/10324/50778
    Tipo de versión
    info:eu-repo/semantics/publishedVersion
    Derechos
    openAccess
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    • DEP52 - Artículos de revista [181]
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