2026-05-05T20:58:37Zhttps://uvadoc.uva.es/oai/request

oai:uvadoc.uva.es:10324/507782022-07-18T09:32:56Zcom_10324_1179com_10324_931com_10324_894col_10324_1306

00925njm 22002777a 4500 dc Fernandez Ruiz, Mario author Arias Rodriguez, Manuel author Campistol Plana, Josep María author Navarro Ortega, David author Gómez Huertas, Ernesto author Gómez Márquez, Gonzalo author Díaz Gómez, Juan Manuel author Hernández Marrero, Domingo author Bernal Blanco, Gabriel author Cofán Pujol, Frederic author Jimeno García, Luisa author Franco Esteve, Antonio author Gonzalez Monte, Esther author Moreso Mateos, Francesc author Gómez Alamillo, Carlos author Mendiluce Herrero, Alicia author Luna Huerta, Enrique author Aguado García, José María author 2015 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. Transplant International, 2015, vol. 28, n. 9, p. 1042-1054 0934-0874 https://uvadoc.uva.es/handle/10324/50778 10.1111/tri.12586 1042 9 1054 Transplant International 28 Riñones - Trasplante SIDA (Enfermedad) Cytomegalovirus prevention strategies in seropositive kidney transplant recipients: an insight into current clinical practice