Comparison of Polymerase Chain Reaction From Plasma and Buffy Coat With Antigen Detection and Occurrence of Immunoglobulin M for the Demonstration of Cytomegalovirus Infection After Liver Transplantation

Schmidt, C. A.; Oettle, Helmut; Peng, Ruoqi; Neuhaus, P.; Blumhardt, G.; Lohmann, R; Wilborn, Freimut; Osthoff, K; Oertel, Joachim; Timm, H.

doi:10.1097/00007890-199504000-00010

Cited by 77 publications

(42 citation statements)

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“…These studies have demonstrated that serology is generally of limited clinical utility for the acute diagnosis of CMV disease, when compared with molecular assays. For example, in a study of 30 liver transplant recipients, positive PCR and antigenemia test results generally preceded the onset of symptoms; however, IgM detection occurred at a median of 2.5 weeks after onset of disease (13). In a study of 42 liver and kidney transplant recipients, IgG or IgM serological responses did not differ between symptomatic and asymptomatic patients, and usually occurred only after the onset of symptoms (14).…”

Section: Discussionmentioning

confidence: 97%

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Clinical Utility of Cytomegalovirus (CMV) Serology Testing in High-risk CMV D+/R- Transplant Recipients

Humar

Mazzulli

Moussa

et al. 2005

American Journal of Transplantation

146

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Late-onset cytomegalovirus (CMV) disease is a significant problem in D+/R− solid organ transplant (SOT)patients who receive antiviral prophylaxis. We assessed the clinical utility of CMV IgG and IgM serology testing for predicting late-onset CMV disease. We evaluated 352 D+/R− transplant recipients who participated in a trial comparing 100 days of ganciclovir versus valganciclovir prophylaxis. CMV serology was assessed on day 28, 56, 100, and 6 and 12 months post-transplant. IgG seroconversion occurred in 26.9% of patients by day 100, and in 63.4% and 75.3% by 6 and 12 months, respectively. IgM seroconversion occurred in 8.3%, 41.8% and 54.9% by day 100, month 6 and month 12, respectively. Seroconversion by day 100 (end of prophylaxis) was not predictive of subsequent CMV disease (CMV disease 13.3% if seropositive vs. 17.8% if seronegative; p = NS). However, at 6 months post-transplant, IgG serostatus was predictive of subsequent CMV disease between month 6 and 12 (CMV disease 1.3% if seropositive vs. 10.0% if seronegative; p = 0.002). In D+/R− patients, CMV serology testing is for the most part not clinically useful for predicting subsequent disease. However, seroconversion by 6 months may be useful for identifying patients at risk of late-onset CMV disease.

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Section: Discussionmentioning

confidence: 97%

“…Previous studies have assessed the utility of serology for diagnosis of CMV disease (13)(14)(15). These studies have demonstrated that serology is generally of limited clinical utility for the acute diagnosis of CMV disease, when compared with molecular assays.…”

Section: Discussionmentioning

confidence: 99%

Clinical Utility of Cytomegalovirus (CMV) Serology Testing in High-risk CMV D+/R- Transplant Recipients

Humar

Mazzulli

Moussa

et al. 2005

American Journal of Transplantation

146

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“…CMV serology is also useful for screening potential blood donors. Serology is an insensitive marker of active CMV infection in the organ transplant population and is therefore of limited diagnostic usefulness (282,409,482). Many patients with positive CMV cultures do not show concomitant evidence of seroconversion (343).…”

Section: Serologymentioning

confidence: 99%

New Strategies for Prevention and Therapy of Cytomegalovirus Infection and Disease in Solid-Organ Transplant Recipients

Sia¹,

Patel²

2000

Clinical Microbiology Reviews

220

181

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“…Introduction of newer diagnostic methods and therapeutic agents have improved the outcome of CMV infection after OLT during the past decades [39]. Several prophylactic protocols are used today to prevent CMV infection [44].…”

Section: Discussionmentioning

confidence: 99%

“…Suspected PCP was confirmed by Grocott-Gomori methenamine-silver nitrate stain [14]. Assessment for CMV was performed by testing the immediate early antigen, or detecting the virus in the BAL using polymerase chain reaction (PCR) [39]. Treatment Treatment of Legionella pneumophila was commenced with erythromycin (1.5-2 g/day in three to four doses), and six patients received a combination therapy of erythromycin and rifampicin (1.2 g daily in two doses).…”

Section: Pneumoniamentioning

confidence: 99%

Simultaneous splenectomy increases risk for opportunistic pneumonia in patients after live transplantation

Neumann¹,

Langrehr²,

Kaisers³

et al. 2002

Transplant Int

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Life threatening pneumonias after liver transplantation are often caused by opportunistic pathogens such as Legionella pneumophila, Pneumocystis carinii, Aspergillus species and cytomegalovirus (CMV). Due to the high incidence of morbidity and mortality caused by these pneumonias we reviewed 700 liver transplants for risk factors for the development of opportunistic pneumonia. Immunosuppression was commenced as either cyclosporin A-or tacrolimusbased protocols. In a subgroup of patients, splenectomy was performed simultaneously with liver transplantation ( n = 57). Overall 60 opportunistic pneumonias occurred in 700 liver transplants. Using a stepwise logistic regression analysis, we found that OKT3 treatment and simultaneous splenectomy revealed a significantly increased risk for opportunistic pneumonia. Our study identified splenectomy as a major risk factor for the development of opportunistic pneumonia after liver transplantation. In these patients prophylactic protocols and early diagnosis may improve the long-term outcome.

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Comparison of Polymerase Chain Reaction From Plasma and Buffy Coat With Antigen Detection and Occurrence of Immunoglobulin M for the Demonstration of Cytomegalovirus Infection After Liver Transplantation

Cited by 77 publications

References 0 publications

Clinical Utility of Cytomegalovirus (CMV) Serology Testing in High-risk CMV D+/R- Transplant Recipients

Clinical Utility of Cytomegalovirus (CMV) Serology Testing in High-risk CMV D+/R- Transplant Recipients

New Strategies for Prevention and Therapy of Cytomegalovirus Infection and Disease in Solid-Organ Transplant Recipients

Simultaneous splenectomy increases risk for opportunistic pneumonia in patients after live transplantation

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