Cytomegalovirus Donor Seropositivity Negatively Affects Survival After Heart Transplantation.

Autor:	Heim C; Department of Cardiac Surgery, University of Erlangen-Nuremberg, Erlangen, Germany., Müller PP; Department of Cardiac Surgery, University of Erlangen-Nuremberg, Erlangen, Germany., Tandler R; Department of Cardiac Surgery, University of Erlangen-Nuremberg, Erlangen, Germany., Cherikh WS; United Network for Organ Sharing, Richmond, VA., Toll AE; United Network for Organ Sharing, Richmond, VA., Stehlik J; Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, UT., Weyand M; Department of Cardiac Surgery, University of Erlangen-Nuremberg, Erlangen, Germany., Khush KK; Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA., Ensminger SM; Department of Cardiac Surgery, University Luebeck, Luebeck, Germany.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2022 Jun 01; Vol. 106 (6), pp. 1243-1252. Date of Electronic Publication: 2022 Sep 23.
DOI:	10.1097/TP.0000000000003961
Abstrakt:	Background: Prior studies have shown that cytomegalovirus (CMV) infection is a risk factor for the development of cardiac allograft vasculopathy (CAV) and is associated with reduced long-term survival after heart transplantation (HTx). The aim of this International Society for Heart and Lung Transplantation Transplant Registry study was to compare posttransplant survival in different CMV donor:recipient serologic combinations. Methods: We performed a retrospective cohort study, using the International Society for Heart and Lung Transplantation Thoracic Transplant Registry, on 15 885 adult primary heart transplant recipients with known CMV serologic status between July 2004 and June 2014. Posttransplant survival and risk of developing CAV were compared across 4 groups: CMV-seronegative recipients (R-) receiving CMV-positive grafts (D+), intermediate-risk patients (D+R+ and D-R+), and low-risk patients (D-R-). Results: Baseline characteristics (donor/recipient age, body mass index, recipient serum creatinine, blood group, donor cause of death, recipient diagnosis, and ischemic time) were mostly balanced between the groups. Kaplan-Meier survival analyses over a follow-up of 10 y revealed significantly worse survival for both D+ groups as compared to the CMV low-risk group (D+R+: 56.61% [95% confidence interval, 53.94-59.41] versus D-R-: 63.09% [59.74-66.64] P < 0.01 and D+R-: 57.69% [56.03-59.39] versus D-R-; P < 0.001), whereas recipient seropositivity alone was not associated with reduced survival (D-R+ versus D-R-P = 0.178). The risk of developing CAV after HTx was not significantly increased in D+ as compared to D- groups. Conclusions: In a large contemporary cohort, CMV status at the time of HTx was not associated with CAV development. However, there was a significant association between donor CMV seropositivity and reduced short- and long-term survival after HTx. Approaches to mitigate the impact of CMV on posttransplant survival are needed. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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