期刊
TRANSPLANT INFECTIOUS DISEASE
卷 20, 期 3, 页码 -出版社
WILEY
DOI: 10.1111/tid.12877
关键词
cytomegalovirus; lung transplant; multicenter cohort study; stem cell transplant
资金
- Centers for Disease Control and Prevention
BackgroundMost studies of post-transplant CMV infection have focused on either solid organ or hematopoietic cell transplant (HCT) recipients. A large prospective cohort study involving both lung and HCT recipients provided an opportunity to compare the epidemiology and outcomes of CMV infections in these 2 groups. MethodsPatients were followed up for 30months in a 6-center prospective cohort study. Data on demographics, CMV infections, tissue-invasive disease, recurrences, rejection, and immunosuppression were recorded. ResultsThe overall incidence of CMV infection was 83/293 (28.3%) in the lung transplant group and 154/444 (34.7%) in the HCT group (P=.0706). Tissue-invasive CMV disease occurred in 8/83 (9.6%) of lung and 6/154 (3.9%) of HCT recipients with CMV infection, respectively (P=.087). Median time to CMV infection was longer in the lung transplant group (236 vs 40days, P<.0001), likely reflecting the effects of prophylaxis vs preemptive therapy. Total IgG levels of < 350mg/dL in lung recipients and graft vs host disease (GvHD) in HCT recipients were associated with increased CMV risk. HCT recipients had a higher mean number of CMV episodes (P=.008), although duration of viremia was not significantly different between the 2 groups. CMV infection was not associated with reduced overall survival in either group. ConclusionsCurrent CMV prevention strategies have resulted in a low incidence of tissue-invasive disease in both lung transplant and HCT, although CMV viremia is still relatively common. Differences between the lung and HCT groups in terms of time to CMV and recurrences of CMV viremia likely reflect differences in underlying host immunobiology and in CMV prevention strategies in the modern era.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据