Publication
Late Cytomegalovirus Infection in Kidney Transplant Recipients after a Six-Month Prevention Protocol
| dc.contributor.author | Cunha, L | |
| dc.contributor.author | Laranjinha, I | |
| dc.contributor.author | Birne, R, et al. | |
| dc.date.accessioned | 2019-05-13T11:30:38Z | |
| dc.date.available | 2019-05-13T11:30:38Z | |
| dc.date.issued | 2019 | |
| dc.description.abstract | BACKGROUND: Despite a reduction in the incidence of cytomegalovirus (CMV) infections after kidney transplantation, less is known about late CMV infection in kidney transplant recipients. OBJECTIVE: To assess incidence of CMV infection in a cohort of patients under a high surveillance CMV prevention protocol and identify factors associated with late CMV infection. METHODS: Analysis of a consecutive cohort of 181 kidney allograft recipients between January 2012 and Aug 2015. CMV prevention-protocol consisted of 6-month universal prophylaxis and pre-emptive therapy for high-risk group (D+/R- or patients submitted to lymphocyte-depleting agent for induction or rejection treatment) and pre-emptive therapy for standard-risk group (D±/R+). Stopping valganciclovir was followed by CMV screening in the next two appointments. RESULTS: CMV infection was identified in 73 of 181 patients; the rate in high-risk group and standard-risk group was similar (p=0.443). However, in the latter group, the infection occurred mostly in the first 6 months. Late CMV infection occurred in 25 of 181 patients (5 of standard-risk group and 20 of high-risk group), after a median (IQR) of 253 (230.3-312.3) days after transplantation and 55 (41-89.5) days after the protocol period. Screening for CMV after valganciclovir discontinuation revealed 56% of late CMV infections. In high-risk group, D+/R- was associated with late CMV infection (HR 2.7, p=0.039) and in standard-risk group; lower age was associated with late CMV infection (HR 0.89, p=0.02). CONCLUSION: The incidence of CMV infection was similar to that reported in the literature. In high-risk patients, antigenemia surveillance during prophylaxis did not appear to reduce late CMV infections. Antigenemia screening after valganciclovir had limited results in the diagnosis of late CMV infection. D+/R- was associated to late CMV infection in high-risk group. Lower age appeared to influence late CMV infection in standard-risk group. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Int J Organ Transplant Med. 2019;10(1):1-12 | pt_PT |
| dc.identifier.issn | 2008-6490 | |
| dc.identifier.uri | http://hdl.handle.net/10400.10/2239 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Avicenna Organ Transplantation Institute | pt_PT |
| dc.relation.publisherversion | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416999/pdf/ijotm-10-001.pdf | pt_PT |
| dc.subject | Cytomegalovirus infections | pt_PT |
| dc.subject | Kidney transplantation | pt_PT |
| dc.subject | Risk factors | pt_PT |
| dc.title | Late Cytomegalovirus Infection in Kidney Transplant Recipients after a Six-Month Prevention Protocol | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.conferencePlace | Shiraz | pt_PT |
| oaire.citation.title | International journal of organ transplantation medicine | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |