RT info:eu-repo/semantics/article
T1 Cytomegalovirus prevention strategies in seropositive kidney transplant recipients: an insight into current clinical practice
A1 Fernandez Ruiz, Mario
A1 Arias Rodriguez, Manuel
A1 Campistol Plana, Josep María
A1 Navarro Ortega, David
A1 Gómez Huertas, Ernesto
A1 Gómez Márquez, Gonzalo
A1 Díaz Gómez, Juan Manuel
A1 Hernández Marrero, Domingo
A1 Bernal Blanco, Gabriel
A1 Cofán Pujol, Frederic
A1 Jimeno García, Luisa
A1 Franco Esteve, Antonio
A1 Gonzalez Monte, Esther
A1 Moreso Mateos, Francesc
A1 Gómez Alamillo, Carlos
A1 Mendiluce Herrero, Alicia
A1 Luna Huerta, Enrique
A1 Aguado García, José María
K1 Riñones - Trasplante
K1 SIDA (Enfermedad)
K1 3205.06 Nefrología
AB 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 (antiviralprophylaxis 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.
PB European Society for Organ Transplantation (ESOT)
SN 0934-0874
YR 2015
FD 2015
LK https://uvadoc.uva.es/handle/10324/50778
UL https://uvadoc.uva.es/handle/10324/50778
LA eng
NO Transplant International, 2015, vol. 28, n. 9, p. 1042-1054
NO Producción Científica
DS UVaDOC
RD 22-nov-2024