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- Title
Comparison of prophylaxis and preemptive strategy as cytomegalovirus prevention in liver transplant recipients.
- Authors
Camus, Christophe; Poinot, Mélanie; Pronier, Charlotte; Rayar, Michel; Neillon, Anne Le; Latournerie, Marianne; Lagathu, Gisèle; Revest, Matthieu
- Abstract
Objectives: Prophylaxis (P) or pre‐emptive strategy (PS) in high‐risk liver transplant recipients (LTRs) are either recommended. We compared the results of each strategy. Methods: Two groups of LTR transplanted during two consecutive periods were compared. Only cytomegalovirus (CMV)‐mismatched LTR (Donor +/ Recipient ‐) were included. The primary endpoints were: the onset of polymerase chain reaction‐based DNAemia and the proportion of patients with CMV disease. A number of episodes of CMV infection, antiviral therapy, ganciclovir resistance, infectious or immunological complications, cost of both strategies, and survival (1, 5, and 10 years) were also compared. Results: Forty‐eight and 60 patients were respectively included in the P and PS groups. Eighteen (38%) in the P group and 56 (93%) in the PS group had CMV DNAemia (p <.0001) with a similar CMV disease rate (16.7% and 15%). Duration of curative therapy was longer in the PS group: 91 days versus 16 (p <.0001). Acute rejection was less frequent (p =.04) and more patients experienced a ganciclovir‐resistant CMV infection in the PS group (10% vs. 0, p =.03). The drug‐associated cost of PS was higher (10 004 vs. 4804€) and the median number of rehospitalization days tended to be higher (6 vs. 4, p =.06). Survival at any time was similar. Conclusion: We reported more CMV DNAemias and ganciclovir‐resistant CMV events with PS. The cost of the PS strategy was higher.
- Subjects
LIVER transplantation; CYTOMEGALOVIRUS diseases; CYTOMEGALOVIRUSES; PREVENTIVE medicine; TREATMENT duration
- Publication
Transplant Infectious Disease, 2024, Vol 26, Issue 3, p1
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.14282