Impact of standardized protocols for cytomegalovirus disease prevention in pediatric solid organ transplant recipients
| Autor: | Heung Bae Kim, Sarah Jones, Jennifer A. Gilarde, Lynne Lewis, Laila S. Alawdah, Lakshmi Ganapathi, Jennifer Blumenthal, Tanvi Sharma, Carly E. Milliren |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Risk Pediatrics medicine.medical_specialty Daclizumab Adolescent 030232 urology & nephrology Cytomegalovirus Disease 030230 surgery Neutropenia Antiviral Agents Asymptomatic Article Basiliximab 03 medical and health sciences 0302 clinical medicine Humans Valganciclovir Medicine Cytomegalovirus disease Child Alemtuzumab Retrospective Studies Transplantation business.industry Infant virus diseases Organ Transplantation Cmv dnaemia medicine.disease Transplant Recipients Cytomegalovirus infection Child Preschool Cytomegalovirus Infections DNA Viral Pediatrics Perinatology and Child Health Female Steroids medicine.symptom business Solid organ transplantation Boston medicine.drug |
| Zdroj: | Pediatr Transplant |
| ISSN: | 1399-3046 1397-3142 |
| Popis: | BACKGROUND: End-organ disease caused by cytomegalovirus (CMV) is a significant cause of morbidity and mortality in pediatric solid organ transplant (SOT) recipients. Pediatric transplant centers have adopted various approaches for CMV disease prevention in this patient population. We observed significant practice variation in CMV testing, prophylaxis and surveillance across SOT groups in our center. To address this, we implemented evidence-based standardized protocols and measured outcomes pre-and post-implementation of these protocols. METHODS: We performed retrospective chart review for SOT recipients from 2009–2014 at Boston Children’s Hospital. Using descriptive statistics, we measured practice improvement in provision of appropriate prophylaxis, occurrence of neutropenia and associated complications, and occurrence of CMV DNAemia and CMV disease pre- and post-intervention. RESULTS: The pre- and post-intervention periods included 141 and 109 patients respectively. With the exception of kidney transplant recipients, provision of appropriate valganciclovir prophylaxis improved across SOT groups post-intervention (p1 episode of neutropenia was greater in the pre-intervention period (30% versus 10%, p |
| Databáze: | OpenAIRE |
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