Patterns of cytomegalovirus infection in simultaneous kidney-pancreas transplant recipients receiving tacrolimus, mycophenolate mofetil, and prednisone with ganciclovir prophylaxis
| Autor: | Hani P. Grewal, Lillian W. Gaber, A.T. Kisilisik, Jennifer Trofe, M. H. Shokouh-Amiri, Robert J. Stratta, A O Gaber, M F Egidi, Agnes Lo, Rita R. Alloway |
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| Rok vydání: | 2001 |
| Předmět: |
Ganciclovir
Human cytomegalovirus Transplantation medicine.medical_specialty biology business.industry medicine.medical_treatment virus diseases Immunosuppression Pancreas transplantation medicine.disease biology.organism_classification Gastroenterology Mycophenolic acid Infectious Diseases Betaherpesvirinae Internal medicine Immunology medicine business Kidney transplantation medicine.drug |
| Zdroj: | Transplant Infectious Disease. 3:8-15 |
| ISSN: | 1398-2273 |
| DOI: | 10.1034/j.1399-3062.2001.003001008.x |
| Popis: | Background: The impact of tacrolimus (TAC), mycophenolate mofetil (MMF) and steroid immunosuppression on cytomegalovirus (CMV) infection in combination with ganciclovir prophylaxis in simultaneous kidney-pancreas transplantation (SKPT) has not been well studied. Methods: A retrospective analysis was made of 75 SKPTs performed between 1 January 1996 and 7 January 1999. All patients received ganciclovir for 3 months, but CMV donor (D)+ / recipient (R)- patients received ganciclovir for 6 months. Results: 16/74 (22%) were CMV D+/R-, 25 (33%) D+/R+, 16 (22%) D-/R+, and 17 (23%) D-/R- (1 patient with unknown donor serology was excluded). The mean time to CMV infection was 198 days post-transplant. The incidence of either CMV infection or tissue invasive CMV disease was 16/74 (22%), including 9 (12%) with CMV infection and 7 (10%) CMV disease. The one-year patient, kidney, and pancreas graft survival rates were 91%, 89%, and 83%, respectively The mean follow-up was 29 months (minimum of 12 months). CMV infection was not associated with an increased incidence of graft failure or mortality. The D+/R- group had the highest incidence of CMV infection (44%) compared with the other serologic groups (17%, P=0.02). Concurrent CMV and rejection occurred more frequently in the D+/R- than the other serologic groups (25% vs. 7%, P= 0.03). The D-/R- group had the best outcomes, with no CMV infection, improved kidney graft survival at the end of follow-up (82% VS. 72%, P= 0.04) and the highest event-free survival (no CMV infection, rejection, or graft loss) when compared to the other groups (76% vs. 33%, P |
| Databáze: | OpenAIRE |
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