Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients

Hodson, EM; Barclay, PG; Craig, Jonathan C.; Jones, Cheryl; Kable, Kathy; Strippoli, Giovanni F.M.; Vimalachandra, Dushyanthi; Webster, AC

doi:10.1002/14651858.cd003774.pub2

Cited by 101 publications

(130 citation statements)

References 75 publications

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“…CMV is the most common virus pathogen seen in solid organ transplant patients and symptomatic disease is reported in 30–50% of patients 7. The burden of CMV pneumonia specifically is highest in lung, heart and haematopoietic stem-cell transplantation where it confers significant mortality risks 7–9.…”

Section: Discussionmentioning

confidence: 99%

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Shortness of breath in a patient with inflammatory bowel disease

Abbey

Elsmore

2014

BMJ Case Reports

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Cytomegalovirus (CMV) is an important cause of morbidity and mortality in immunocompromised patients. Although immunosuppressive therapy is the mainstay of medical treatment for patients with inflammatory bowel disease, the importance of CMV as a cause of pneumonia in this group is less well recognised. This case report presents a case of shortness of breath, dyspnoea and fever in a 51-year-old man with Crohn's disease on azathioprine and highlights the importance of considering CMV as a cause of pneumonia in this group.

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Section: Discussionmentioning

confidence: 99%

“…The burden of CMV pneumonia specifically is highest in lung, heart and haematopoietic stem-cell transplantation where it confers significant mortality risks 7–9. The incidence of CMV pneumonia postlung transplant has been reportedly as high as 50% 7 9…”

Section: Discussionmentioning

confidence: 99%

Shortness of breath in a patient with inflammatory bowel disease

Abbey

Elsmore

2014

BMJ Case Reports

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“…However, prophylactic regimens can protect recipients from certain infections, and the advent of cytomegalovirus (CMV) prophylaxis has greatly reduced the impact of CMV disease on recipient survival [54,55]. A recent, well-conducted, randomized controlled trial of prophylaxis with valganciclovir for at-risk patients (donor or recipient CMV seropositive) showed a marked reduction in CMV disease incidence for a 12-month course of valganciclovir versus a 3-month course [56].…”

Section: Recent Advancesmentioning

confidence: 99%

Lung transplantation

Meyer¹

2013

F1000Prime Rep

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Lung transplantation may be the only intervention that can prolong survival and improve quality of life for those individuals with advanced lung disease who are acceptable candidates for the procedure. However, these candidates may be extremely ill and require ventilator and/or circulatory support as a bridge to transplantation, and lung transplantation recipients are at risk of numerous post-transplant complications that include surgical complications, primary graft dysfunction, acute rejection, opportunistic infection, and chronic lung allograft dysfunction (CLAD), which may be caused by chronic rejection. Many advances in pre- and post-transplant management have led to improved outcomes over the past decade. These include the creation of sound guidelines for candidate selection, improved surgical techniques, advances in donor lung preservation, an improving ability to suppress and treat allograft rejection, the development of prophylaxis protocols to decrease the incidence of opportunistic infection, more effective therapies for treating infectious complications, and the development of novel therapies to treat and manage CLAD. A major obstacle to prolonged survival beyond the early post-operative time period is the development of bronchiolitis obliterans syndrome (BOS), which is the most common form of CLAD. This manuscript discusses recent and evolving advances in the field of lung transplantation.

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“…[2728] One analysis found that prophylaxis significantly reduced the rate of graft rejection,[28] but the other did not. [27] Oral valganciclovir and intravenous ganciclovir are equally efficacious in preventing CMV infection and disease. [29] Similarly, oral and intravenous ganciclovir yielded similar results.…”

Section: Cytomegalovirusmentioning

confidence: 99%

Post-transplant infections: An ounce of prevention

Jha

2010

Indian J Nephrol

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Infections are the leading cause of hospitalization in transplant recipients. The increased risk of new onset diabetes after transplantation, cardiovascular disease, post-transplant lymphoproliferative disorders adversely affects allograft outcomes. Risk is determined by epidemiologic exposure, immunosuppressive therapy and prophylaxis. The predictable sequence of appearance of infections helps in making management decisions. High likelihood of infections with unusual and multiple organisms necessitates aggressive use of imaging techniques and invasive procedures. Serologic tests depend upon antibody response and are unreliable. Nucleic acid based assays are sensitive, rapid, and allow detection of subclinical infection and assessment of response to therapy. Preventive steps include screening of donors and recipients and vaccination. All indicated vaccines should be administered before transplantation. Inactivated vaccines can be administered after transplantation but produce weak and transient antibody response. Boosters may be required once antibody titers wane. Post-transplant chemoprophylaxis includes cotrimoxazole for preventing urinary tract infections, pneumocystis and Nocardia infections; ganciclovir, valganciclovir, or acyclovir for cytomegalovirus related complications in at-risk recipients; and lamivudine for prevention of progressive liver disease in HBsAg positive recipients. Viral load monitoring and pre-emptive treatment is used for BK virus infection. Infection with new organisms has recently been reported, mostly due to inadvertent transmission via the donor organ.

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Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients

Cited by 101 publications

References 75 publications

Shortness of breath in a patient with inflammatory bowel disease

Shortness of breath in a patient with inflammatory bowel disease

Lung transplantation

Post-transplant infections: An ounce of prevention

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