Evaluation of Two Different CMV-Immunoglobulin Regimens for Combined CMV Prophylaxis in High-Risk Patients following Lung Transplant.

Autor:	Mora VM; Service of Respiratory Medicine, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain.; Genetic Epidemiology and Atherosclerosis in Systemic Inflammatory Diseases Group, IDIVAL, 39008 Santander, Spain., Ussetti P; Department of Neumology, Hospital Puerta de Hierro, Majadahonda, 28222 Madrid, Spain., de Pablo A; Department of Neumology, Hospital Universitario 12 de octubre, 28041 Madrid, Spain., Iturbe D; Service of Respiratory Medicine, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain.; Genetic Epidemiology and Atherosclerosis in Systemic Inflammatory Diseases Group, IDIVAL, 39008 Santander, Spain., Laporta R; Department of Neumology, Hospital Puerta de Hierro, Majadahonda, 28222 Madrid, Spain., Alonso R; Department of Neumology, Hospital Universitario 12 de octubre, 28041 Madrid, Spain., Aguilar M; Department of Neumology, Hospital Puerta de Hierro, Majadahonda, 28222 Madrid, Spain., Quezada CA; Department of Neumology, Hospital Universitario 12 de octubre, 28041 Madrid, Spain., Cifrián JM; Service of Respiratory Medicine, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain.; Genetic Epidemiology and Atherosclerosis in Systemic Inflammatory Diseases Group, IDIVAL, 39008 Santander, Spain.
Jazyk:	angličtina
Zdroj:	Microorganisms [Microorganisms] 2022 Dec 22; Vol. 11 (1). Date of Electronic Publication: 2022 Dec 22.
DOI:	10.3390/microorganisms11010032
Abstrakt:	Background: The clinical benefits of the common off-label use of cytomegalovirus (CMV)-specific immunoglobulin (CMV-Ig) combined with antivirals in organ transplantation have not been previously assessed. The objective was to compare the risk of CMV infection and other post-transplantation outcomes between two CMV-Ig prophylaxis regimens in lung transplant recipients; Methods: Retrospective study of 124 donor CMV positive/recipient negative (D+/R-) patients receiving preventive ganciclovir/valganciclovir for 12 months, of whom 62 received adjunctive CMV-Ig as per label indication (short regimen [SR-Ig]; i.e., 7 doses over 2.5 months) and were compared to 62 who received an extended off-label regimen (ER-Ig) consisting of 17 doses over one year after transplantation. Results: The incidence of CMV infection or disease, acute rejection, chronic lung allograft dysfunction, and survival did not differ between the two CMV-Ig schedules. Although the time to the first CMV infection after transplantation was shorter in the ER-Ig than in the SR-Ig adjunctive group (log-rank: p = 0.002), the risk was independently predicted by antiviral cessation (odds ratio = 3.74; 95% confidence interval = 1.04-13.51; p = 0.030), whereas the CMV-Ig schedule had no effect. Conclusions: Extending the adjunctive CMV-Ig prophylaxis beyond the manufacturer's recommendations up to one year does not confer additional clinical benefits regarding lung post-transplantation outcomes.
Databáze:	MEDLINE
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