GESITRA-SEIMC/REIPI recommendations for the management of cytomegalovirus infection in solid-organ transplant patients

Torre‐Cisneros, Julián; Fariñas, María Carmen; Castón, Juan José; Aguado, José María; Cantisán, Sara; Carratalà, Jordi; Cervera, Carlos; Cisneros, José Miguel; Cordero, Elisa; Crespo-Leiro, María G.; Fortün, Jesús; Frauca, E; Gavaldá, Joan; Gil-Vernet, S.; Gurguí, Mercé; Len, Óscar; Lumbreras, Carlos; Marcos, M.Á.; Martín-Dávila, Pilar; Monforte, Vı́ctor; Montejo, Miguel; Moreno, Asunción; Muñóz, Patricia; Navarro, David; Pahissa, Albert; Pérez, José Luís; Rodriguez-Bernot, A.; Rumbao, José; Juan, Rafael San; Santos, Francisco; Varó, Evaristo; Zurbano, Felipe

doi:10.1016/j.eimc.2011.05.022

Cited by 86 publications

(77 citation statements)

References 242 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the IMPACT study, the overall reported incidence of leukopenia was 38% in the 200-day group versus 26% in the 100-day group; however, the median laboratory white blood cell counts and the incidences of reported neutropenia, febrile neutropenia, agranulocytosis, anemia, thrombocytopenia and pancytopenia were comparable between the two groups (11). Guidelines suggest that management of leukopenia include reduction of other bone marrow suppressive medications, and either stopping or continuing but not dose reducing (val)ganciclovir (2,4). When the antiviral prophylaxis is stopped, clinicians may wish to switch to preemptive therapy.…”

Section: Antiviral Medications For Universal Prophylaxis and Preemptimentioning

confidence: 99%

See 1 more Smart Citation

CMV: Prevention, Diagnosis and Therapy

Kotton

2013

American Journal of Transplantation

248

218

View full text Add to dashboard Cite

Cytomegalovirus (CMV) is the most common infection after organ transplantation and has a major impact on morbidity, mortality and graft survival. Optimal prevention, diagnosis and treatment of active CMV infection enhance transplant outcomes, and are the focus of this section. Methods to prevent CMV include universal prophylaxis and preemptive therapy; each has its merits, and will be compared and contrasted. Diagnostics have improved substantially in recent years, both in type and quality, allowing for more accurate and savvy treatment; advances in diagnostics include the development of an international standard, which should allow comparison of results across different methodologies, and assays for cellular immune function against CMV. Therapy primarily involves ganciclovir, now rendered more versatile by data suggesting oral therapy with valganciclovir is not inferior to intravenous therapy with ganciclovir. Treatment of resistant virus remains problematic, but is enhanced by the availability of multiple novel therapeutic agents.

show abstract

Section: Antiviral Medications For Universal Prophylaxis and Preemptimentioning

confidence: 99%

“…Treatment of resistant virus remains problematic, but is enhanced by the availability of better diagnostics as well as multiple novel therapeutic agents. Recent guidelines are helpful in guiding optimal management (1)(2)(3)(4). These various aspects of CMV management will be covered in this review.…”

Section: Introductionmentioning

confidence: 99%

CMV: Prevention, Diagnosis and Therapy

Kotton

2013

American Journal of Transplantation

248

218

View full text Add to dashboard Cite

show abstract

“…El segundo, presentó resistencia clínica y virológica al tratamiento con ganciclovir y valganciclovir, por lo que recibió foscarnet, según se recomienda en la literatura científica 3,4,27 . El fármaco es un análogo orgánico de pirofosfato inorgánico, que se une a la ADN polimerasa 28 , con lo que las cargas virales del paciente fueron indetectables.…”

Section: Discussionunclassified

“…A pesar de las medidas preventivas que se efectúan para evitar las infecciones, el desarrollo de éstas por bacterias, virus u hongos genera una importante morbilidad y mortalidad en los pacientes receptores de trasplantes del corazón 2 ; un patógeno viral de consideración en los pacientes que reciben trasplante de órganos sólidos es citomegalovirus (CMV) 3,4 . La infección por CMV se puede establecer mediante la presencia de replicación viral, detección de las proteínas virales (antigenemia) y su material genético o el crecimiento in vitro del virus en pacientes sin alguna sintomatología.…”

Section: Introductionunclassified

Enfermedad por citomegalovirus en pacientes receptores de trasplante de corazón en un centro de referencia nacional

Rojas-Contreras

Cruz-Ku

Valcárcel

2016

Rev. chil. infectol.

View full text Add to dashboard Cite

Introduction: Heart transplantation remains as the treatment of choice when the heart failure is refractory to the medical or surgical therapy. Therefore, cytomegalovirus disease is an important post-heart-transplant infectious complication. Aims: To describe the prevalence and clinical characteristics of the cytomegalovirus disease after heart transplant surgery. Materials and Methods: A retrospective, descriptive study was conducted. It enrolled 35 heart-transplant patients attended in the Cardiovascular National Institute (INCOR), between 2010 and 2015. The information was obtained through the review of medical records. The demographic and relevant clinical variables were analyzed for the cytomegalovirus disease cases. Results: The population mean age was 39.49 ± 15.07 years and most of them were male patients (63%). The prevalence of the cytomegalovirus disease was 5.7% (two patients), both were seronegative for cytomegalovirus before transplantation. One of the patients had the disease before finishing the valganciclovir prophylaxis and the other after the end of it. Conclusion: The prevalence of the cytomegalovirus disease is slightly lower than in other studies. Moreover, the cytomegalovirus disease can remit with a prompt diagnosis and the proper medical treatment.

show abstract

“…Una vez establecido el diagnostico, se recomienda reducir o suspender los anticalcineurinicos, inhibidores mTOR y micofenolato mofetilo a fin de controlar la infección por citomegalovirus (12,13). La metilprednisolona EV puede reducir la activación de macrófagos y citoquinas.…”

Section: Criterios Clínicosunclassified

Síndrome hemofagocítico secundario a infección por Citomegalovirus post trasplante renal. Reporte del primer caso en Perú

Gonzales-Hamada¹,

Anticona²,

Bellido³

et al. 2017

Rev Med Hered

View full text Add to dashboard Cite

RESUMENSe presenta el caso de una paciente trasplantada renal de 60 años, quien presentó síndrome hemofagocítico secundario a infección por Citomegalovirus (CMV). La presentación clínica fue inespecífica con fiebre, bicitopenia, niveles altos de ferritina, hepatoesplenomegalia y hemofagocitósis confirmada por aspirado de médula ósea; evoluciono a shock séptico, siendo trasladada grave a la Unidad de cuidados intensivos, respondiendo favorablemente luego de 3 semanas de tratamiento antibiótico con meropenen, vancomicina, retiro de inmunosupresores, ganciclovir, caspofungina, y metilprednisolona. Cursó durante toda su complicación con función renal normal. En Perú no se ha descrito algún caso de síndrome hemofagocítico secundario a infección por Citomegalovirus en un paciente trasplantado renal, por lo que consideramos importante su difusión. Es importante la sospecha precoz de esta patología, ya que la mortalidad es alta llegando al 50% y la evolución depende de un tratamiento adecuado y temprano, tal como sucedió con nuestra paciente.PALABRAS CLAVE: Linfohistiocitosis hemofagocítica, citomegalovirus, trasplante de riñón. (Fuente: DeCS BIREME). SUMMARYWe report the case of a 60-year-old female renal transplant patient who presented with an hemophagocytic syndrome due to cytomegalovirus infection. Clinical presentation was non-specific with fever, bicytopenia, high ferritin levels, visceromegaly and hemophagocytosis documented in a bone marrow aspiration. The patient progressed to septic shock for which was transferred to the ICU where she recovered uneventfully after 3 weeks of treatment that included meropenem, vancomycin, suspension of immunosuppressive drugs, ganciclovir, casponfungin and methylprednisolone. Renal function was not altered throughout. This is the first report of this condition in Peru. Early suspicion is paramount as mortality is high and prognosis depends on early initiation of treatment as in this patient.

show abstract

GESITRA-SEIMC/REIPI recommendations for the management of cytomegalovirus infection in solid-organ transplant patients

Cited by 86 publications

References 242 publications

CMV: Prevention, Diagnosis and Therapy

CMV: Prevention, Diagnosis and Therapy

Enfermedad por citomegalovirus en pacientes receptores de trasplante de corazón en un centro de referencia nacional

Síndrome hemofagocítico secundario a infección por Citomegalovirus post trasplante renal. Reporte del primer caso en Perú

Contact Info

Product

Resources

About