Resource utilization of cytomegalovirus immune globulin in prevention and treatment of cytomegalovirus infection in pediatric heart transplantation

Autor:	Jennifer Carapellucci, Katie Namtu, David M. Berman, Alfred Asante-Korang, Bethany L. Wisotzkey, Gabriella Blyumin, Diane Krasnopero, Amy L. Kiskaddon, Brian K. Brown
Rok vydání:	2019
Předmět:	Graft Rejection Male medicine.medical_specialty Adolescent Cytomegalovirus immune globulin Cytomegalovirus Immunoglobulins 030230 surgery Antiviral Agents 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Internal medicine medicine Humans Child Retrospective Studies Transplantation Cardiac allograft business.industry Graft Survival Infant Retrospective cohort study Prognosis Discontinuation Cytomegalovirus infection Child Preschool Cohort Cytomegalovirus Infections Heart Transplantation 030211 gastroenterology & hepatology Female Pediatric heart transplantation business Resource utilization Follow-Up Studies
Zdroj:	Clinical transplantationREFERENCES. 33(12)
ISSN:	1399-0012
Popis:	BACKGROUND There is debate whether cytomegalovirus immunoglobulin (CMV-Ig) is also needed for CMV prevention in heart transplant recipients in the era of good anti-viral drugs. METHODS We conducted a cost-savings quality initiative on CMV-Ig eventually leading to discontinuation of routine use of CMV-Ig for CMV prevention. Subsequently, a retrospective cohort study was conducted, comparing patients in cohort I (CMV-Ig plus anti-viral drugs, 2013-2015) to cohort II (anti-virals alone, 2015-2017). The medication acquisition costs and outcomes of CMV infection were assessed. RESULTS There were 39 total patients: 22/39(56%) in cohort I, with mean follow-up of 35.14 ± 17.38 months and 17/39(44%) in cohort II, mean follow-up of 19.12 ± 7.08 months. In cohort I, 5/22(22.7%) patients died from causes unrelated to CMV and 0/17 in cohort II died. There were 5/22(22.7%) patients in cohort I, and 2/17(9%) patients in cohort II that developed CMV infection (P = .508). Freedom from rejection was 81.8% (18/22) in cohort I, and 71% (12/17) in cohort II (P = .46), and 100% for allograft vasculopathy. There was significant reduction in medication acquisition cost following the protocol change of $260 839 or $15 343 per patient. CONCLUSION Our study demonstrated an acquisition cost savings with similar clinical outcomes utilizing anti-viral CMV prophylaxis alone vs anti-viral prophylaxis plus CMV-Ig.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d1be95c2c916183a978373da11607717 https://pubmed.ncbi.nlm.nih.gov/31692121 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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