Anti-viral prophylaxis reduces the incidence of lymphoproliferative disease in lung transplant recipients

Malouf, M.A.; Chhajed, Prashant N.; Hopkins, P.; Plit, M.; Turner, Jennifer; Glanville, Allan R.

doi:10.1016/s1053-2498(01)00407-7

Cited by 82 publications

(60 citation statements)

References 25 publications

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“…Notably, ganciclovir was associated with a 38% risk reduction of early PTLD for each 30 days during an individual's first year post-transplant [30]. In a study of lung transplant patients, researchers also found a reduction of PTLD from 4.2% among a historical comparison group to 0.76% in recipients of prophylaxis with either acyclovir, valacyclovir, or ganciclovir [25].…”

Section: Discussionmentioning

confidence: 99%

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Valganciclovir for the Suppression of Epstein-Barr Virus Replication

Yager

Magaret

Kuntz³

et al. 2017

The Journal of Infectious Diseases

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Valganciclovir for the Suppression of Epstein-Barr Virus Replication Jessica Eve YagerChair of the Supervisory Committee:Professor Anna Wald Department of EpidemiologyEpstein-Barr virus (EBV), a common herpesvirus, is the main causative agent of infectious mononucleosis.Following primary infection, EBV persists in host cells and can cause B cell transformation, leading to the development of EBV-associated malignancies. The role for antiviral therapy in treating and preventing EBV-associated disease remains unclear. Using oral swabs collected from a randomized, double-blind, placebo-controlled crossover study that our group had previously conducted, we sought to determine the impact of valganciclovir on both the rate and quantity of oral EBV shedding. Twenty-six men were randomly assigned to receive either oral valganciclovir, 900mg daily, or oral placebo once daily for eight weeks. Participants then received no study drug for a two week "washout period," followed by the alternate treatment (valganciclovir or placebo) for a second eight-week period. Valganciclovir reduced the proportion of days on which EBV was detected by 72% (relative risk 0.28, 95% confidence interval 0.08-0.55; p=0.003), and reduced the quantity of virus detected by 0.77 logs (95% confidence interval 0.62-0.91 logs; p<0.001). These results were consistent regardless of participants' HIV status and use of antiretroviral therapy. These findings could have significant clinical applications in both the treatment and prevention of EBV-associated disease. 4Background and Significance:

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Section: Discussionmentioning

confidence: 99%

“…Among those who do develop PTLD, mortality is high: 87.5% in one retrospective cohort in Australia [25]. Patients with increased rates of EBV shedding and higher quantities of EBV shed have been found to be at greater risk for the development of PTLD [26].…”

Section: Discussionmentioning

confidence: 99%

Valganciclovir for the Suppression of Epstein-Barr Virus Replication

Yager

Magaret

Kuntz³

et al. 2017

The Journal of Infectious Diseases

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“…Epstein Barr Virus is a well-documented pathogen following lung transplantation with historical reports of post transplant lymphoproliferative disease in 2-5% of all lung transplant recipients and up to 30% of donor/recipient Epstein Barr virus mismatches. More recently, routine use of current antiviral prophylaxis strategies, more judicious use of immunosuppression regimens in at risk recipients, and improved treatment options have anecdotally been associated with improved outcomes (Malouf, Chhajed et al 2002).…”

Section: Infectionsmentioning

confidence: 99%

Lung Transplantation for Pulmonary Sarcoidosis

Keating¹

2011

Sarcoidosis Diagnosis and Management

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“…Standard chemotherapy has been employed for refractory cases but the associated neutropaenia is poorly tolerated by a patient population already profoundly immunosuppressed. There is no proven role for antiviral therapy in the setting of established PTLD, although there is preliminary evidence that the prophylactic use of antiviral agents initiated prior to the rapid replication phase of infection may reduce the subsequent risk of developing PTLD [31,41]. Finally, the technique of adoptive immunotherapy, involving in vitro expansion and subsequent reinfusion of recipient EBV-specific cytotoxic T-cells, holds promise as a novel means of treating PTLD [42].…”

Section: Post-transplant Lymphoproliferative Diseasementioning

confidence: 99%

Medical complications of lung transplantation

Kotloff¹,

Ahya²

2004

Eur Respir J

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Many of the medical complications that arise are the direct consequence of the need to administer potent immunosuppressive agents, with their attendant risks of infection, malignancy and drug toxicity.This article will review the major medical complications, excluding allograft rejection, which may be encountered in the lung transplant recipient. Familiarity with, and vigilance for, these problems should facilitate earlier recognition, more expeditious intervention and more favourable outcomes. Eur Respir J 2004; 23: 334-342. Pulmonary, Allergy, and Critical Care Division,

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Anti-viral prophylaxis reduces the incidence of lymphoproliferative disease in lung transplant recipients

Cited by 82 publications

References 25 publications

Valganciclovir for the Suppression of Epstein-Barr Virus Replication

Valganciclovir for the Suppression of Epstein-Barr Virus Replication

Lung Transplantation for Pulmonary Sarcoidosis

Medical complications of lung transplantation

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