Cytomegalovirus mismatch after heart transplantation: Impact of antiviral prophylaxis and intravenous hyperimmune globulin

Immohr, Moritz Benjamin; Akhyari, Payam; Böttger, Charlotte; Mehdiani, Arash; Dalyanoĝlu, Hannan; Westenfeld, Ralf; Oehler, Daniel; Tudorache, I.; Aubin, Hug; Lichtenberg, Artur; Boeken, Udo

doi:10.1002/iid3.508

Cited by 8 publications

(20 citation statements)

References 16 publications

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“…Ganciclovir/valganciclovir is administered for 90 days post-surgery to most individuals; the exception being seronegative recipients receiving an organ from a seronegative donor (D-/R-). 54 For those considered at highest risk of disease (D+/R-), 3…”

Section: Immunotherapy In the Management Of CMV In Transplant Settingsmentioning

confidence: 99%

“…In the heart transplant setting, Udo Boeken described the CMV prophylaxis regimen in heart transplant recipients adopted by his center at the Heinrich Heine University in Düsseldorf. Ganciclovir/valganciclovir is administered for 90 days post‐surgery to most individuals; the exception being seronegative recipients receiving an organ from a seronegative donor (D‐/R‐) 54 . For those considered at highest risk of disease (D+/R‐), 3 days of CMVIG treatment is added to the management pathway.…”

Section: Understanding the Challenge Of CMV Resistancementioning

confidence: 99%

“…Ganciclovir/valganciclovir is administered for 90 days post‐surgery to most individuals; the exception being seronegative recipients receiving an organ from a seronegative donor (D‐/R‐). 54 For those considered at highest risk of disease (D+/R‐), 3 days of CMVIG treatment is added to the management pathway. Application of this protocol has resulted in survival rates 1‐year post heart transplant of 77.8% in D+/R‐, 74.4% in D‐/R+, 87.5% in D‐/R‐, and 71.7% in D+/R+.…”

Section: Understanding the Challenge Of CMV Resistancementioning

confidence: 99%

See 2 more Smart Citations

Cytomegalovirus in the transplant setting: Where are we now and what happens next? A report from the International CMV Symposium 2021

Kotton

Torre‐Cisneros

Aguado

et al. 2022

Transplant Infectious Dis

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The CMV Symposium in September 2021 was an international conference dedicated to cytomegalovirus (CMV) infection after solid organ or hematopoietic stem cell transplantation. This review provides an overview of the presentations given by the expert faculty, supplemented with educational clinical cases. Topics discussed include CMV epidemiology and diagnosis, the burden of CMV infection and disease, CMV‐specific immunity and management of CMV in transplant settings. Major advances in the prevention and treatment of CMV in the past decade and increased understanding of CMV immunity have led to improved patient outcomes. In the future, management algorithms may be individualized based on the transplant recipient's immune profile, which will mark the start of a new era for patients with CMV.

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Section: Immunotherapy In the Management Of CMV In Transplant Settingsmentioning

confidence: 99%

Section: Understanding the Challenge Of CMV Resistancementioning

confidence: 99%

Section: Understanding the Challenge Of CMV Resistancementioning

confidence: 99%

See 1 more Smart Citation

Cytomegalovirus in the transplant setting: Where are we now and what happens next? A report from the International CMV Symposium 2021

Kotton

Torre‐Cisneros

Aguado

et al. 2022

Transplant Infectious Dis

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“…CMV infection is involved in allograft rejection in pediatric heart transplant recipients [ 12 ]. Also, CMV infection mismatch in donor and recipient patients causes complications impairing outcomes in heart transplantation [ 13 ]. The inflammatory status of chronic heart failure (CHF) patients is directly related to CMV infection.…”

Section: Introductionmentioning

confidence: 99%

Differential effects of CMV infection on the viability of cardiac cells

et al. 2023

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Cytomegalovirus (CMV) is a widely prevalent herpesvirus that reaches seroprevalence rates of up to 95% in several parts of the world. The majority of CMV infections are asymptomatic, albeit they have severe detrimental effects on immunocompromised individuals. Congenital CMV infection is a leading cause of developmental abnormalities in the USA. CMV infection is a significant risk factor for cardiovascular diseases in individuals of all ages. Like other herpesviruses, CMV regulates cell death for its replication and establishes and maintains a latent state in the host. Although CMV-mediated regulation of cell death is reported by several groups, it is unknown how CMV infection affects necroptosis and apoptosis in cardiac cells. Here, we infected primary cardiomyocytes, the contractile cells in the heart, and primary cardiac fibroblasts with wild-type and cell-death suppressor deficient mutant CMVs to determine how CMV regulates necroptosis and apoptosis in cardiac cells. Our results reveal that CMV infection prevents TNF-induced necroptosis in cardiomyocytes; however, the opposite phenotype is observed in cardiac fibroblasts. CMV infection also suppresses inflammation, reactive oxygen species (ROS) generation, and apoptosis in cardiomyocytes. Furthermore, CMV infection improves mitochondrial biogenesis and viability in cardiomyocytes. We conclude that CMV infection differentially affects the viability of cardiac cells.

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“…The effect of donor parameters on outcome and survival after heart transplantation is crucial and is currently one of the most essential topics of organ acceptance [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. A potential donor risk factor for organ quality is the donor length of stay (LOS) in the ICU.…”

Section: Introductionmentioning

confidence: 99%

Outcome and Midterm Survival after Heart Transplantation Is Independent from Donor Length of Stay in the Intensive Care Unit

Oehler

Böttger

Immohr

et al. 2022

Life

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Prolonged treatment of organ donors in the intensive care unit (ICU) may be associated with complications influencing the outcome after heart transplantation (HTx). We therefore aim to explore the potential impact of the donor length of stay (LOS) in the ICU on outcomes in our cohort. We included all patients undergoing HTx in our center between September 2010 and April 2022 (n = 241). Recipients were divided around the median into three groups regarding their donor LOS in the ICU: 0 to 3 days (≤50th percentile, n = 92), 4 to 7 days (50th–75th percentile, n = 80), and ≥8 days (≥75th percentile, n = 69). Donor LOS in the ICU ranged between 0 and 155 days (median 4, IQR 3–8 days). No association between the LOS in the ICU and survival after HTx was observed (AUC for overall survival 0.514). Neither the Kaplan–Meier survival analysis up to 5 years after HTx (Log-Rank p = 0.789) nor group comparisons showed significant differences. Baseline recipient characteristics were comparable between the groups, while the donor baselines differed in some parameters, such as less cardiopulmonary resuscitation prior to HTx in those with a prolonged LOS. However, regarding the recipients’ peri- and postoperative parameters, the groups did not differ in all of the assessed parameters. Thus, in this retrospective analysis, although the donors differed in baseline parameters, the donor LOS in the ICU was not associated with altered recipient survival or outcome after HTx.

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Cytomegalovirus mismatch after heart transplantation: Impact of antiviral prophylaxis and intravenous hyperimmune globulin

Cited by 8 publications

References 16 publications

Cytomegalovirus in the transplant setting: Where are we now and what happens next? A report from the International CMV Symposium 2021

Cytomegalovirus in the transplant setting: Where are we now and what happens next? A report from the International CMV Symposium 2021

Differential effects of CMV infection on the viability of cardiac cells

Outcome and Midterm Survival after Heart Transplantation Is Independent from Donor Length of Stay in the Intensive Care Unit

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