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- Title
Real-World Treatment Patterns of Antiviral Prophylaxis for Cytomegalovirus Among Adult Kidney Transplant Recipients: A Linked USRDS-Medicare Database Study.
- Authors
Raval, Amit D.; Ganz, Michael L.; Fraeman, Kathy; Lorden, Andrea L.; Saravanan, Shanmugapriya; Yuexin Tang; Santos, Carlos A. Q.
- Abstract
Limited data exist on cytomegalovirus (CMV) antiviral treatment patterns among kidney transplant recipients (KTRs). Using United States Renal Database System registry data and Medicare claims (1 January 2011-31 December 2017), we examined CMV antiviral use in 20,601 KTRs who received their first KT from 2011 to 2016. Three-quarters of KTRs started CMV prophylaxis (86.9% of high-, 83.6% of intermediate-, and 31.7% of low-risk KTRs). Median time to prophylaxis discontinuation was 121, 90, and 90 days for high-, intermediate-, and low-risk KTRs, respectively. Factors associated with receiving CMV prophylaxis were highrisk status, diabetes, receipt of a well-functioning kidney graft, greater time on dialysis before KT, panel reactive antibodies =80%, and use of antithymocyte globulin, alemtuzumab, and tacrolimus. KTRs were more likely to discontinue CMV prophylaxis if they developed leukopenia/neutropenia, had liver disease, or had a deceased donor. These findings suggest that adherence to the recommended duration of CMV-prophylaxis for high and intermediate-risk patients is suboptimal, and CMV prophylaxis is overused in low-risk patients.
- Subjects
KIDNEY transplantation; ALEMTUZUMAB; DATABASES; CYTOMEGALOVIRUSES; PREVENTIVE medicine; ADULTS; DEAD; INTERNET content management systems
- Publication
Transplant International, 2024, p1
- ISSN
0934-0874
- Publication type
Article
- DOI
10.3389/ti.2022.10528