CMV‐hyperimmune globulin for preventing cytomegalovirus infection and disease in solid organ transplant recipients: a meta‐analysis

Abstract

Prophylactic administration of CMVIG after solid organ transplantation is associated with improved total survival, reduced CMV disease, and CMV-associated deaths.

CMV: Prevention, Diagnosis and Therapy

“…CMV disease was significantly reduced in all recipients receiving prophylactic CMV immunoglobulin, although it had no impact on CMV infections and clinically relevant rejections (40). A recent analysis of Scientific Registry of Transplant Recipients (SRTR) data in the United States suggests that in pediatric heart transplant recipients, CMV immunoglobulin (with or without antivirals) and antivirals without CMV immunoglobulin were both associated with significantly (p ≤0.05) lower rates of graft loss and death versus no prophylaxis (41).…”

Humanes Cytomegalievirus (HCMV)

“…Angesichts der hohen Durchseuchung und der fehlenden Konsequenzen für Immunkompetente ist eine spezifische Beratung nicht erforderlich. [11,28,[62][63][64] [11,65]). …”

“…der Applikation von seronegativem Blut sind widersprüchlich. Einerseits wird beschrieben, dass die Leukozytendepletion der Verwendung HCMV-seronegativer, nicht leukozytenreduzierter Blutkomponenten äquivalent ist [55,62,63,116,119,[139][140][141][142][143][144][145][146]. Neue Studienergebnisse belegen, dass frisch serokonvertierte Spender die höchsten Viruskonzentrationen im Verlauf einer HCMV-Infektion haben.…”

Intravenous immunoglobulins in liver transplant patients: Perspectives of clinical immune modulation

“…Furthermore, treatment with anti-CMV Ig was identified as independent predictor of beneficial outcome at one year post-LT in multivariate analysis (P = 0.042), and a trend toward increased long-term survival (P = 0.098) was also shown [121] . In a meta-analysis including 11 randomized controlled trials, Bonaros et al [122] reported about improved overall However, in the all-cause death analysis, only one liver transplant study has been included [122] . Kwekkeboom et al [82] did not observe an outcome benefit by CMVIg in 18 liver transplant patients, which was contrary to their experiences with HBIg treatment.…”

“…However, treatment with anti-CMV Ig is currently not a recommended standard in liver transplant recipients [115] . Although well-designed studies on this issue are rare, some larger clinical trials have in the past suggested favourable immuno-balancing capabilities of CMVIg, which are beyond its established antiviral efficacies [80,[119][120][121][122][123][124][125][126] (Table 3). Farges et al [80] reported already in 1996 on a significantly reduced incidence of acute rejection in liver recipients who received a 3-mo course of CMVIg (19%) compared to those who did not (48%; P = 0.01).…”