Quantitative pp65 antigenemia in the diagnosis of cytomegalovirus disease: prospective assessment in a cohort of solid organ transplant recipients

Bernabéu-Wittel, Máximo; Pachón-Ibáñez, J.; Cisneros, José Miguel; Cañas, Elías; Sánchez, María de la Paz; Gómez, Miguel Ángel; Gentil, M.A.; Pachón, Jerónimo

doi:10.1016/j.jinf.2004.10.014

Cited by 18 publications

(10 citation statements)

References 24 publications

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“…CMV Ag-guided pre-emptive therapy has been shown to be effective in preventing CMV disease in HSCT recipients (12,13). In HSCT and organ transplantation recipients, 10 or more positive cells indicate a higher risk of developing CMV disease (10,23). While the clinical significance of CMV reactivation in HSCT recipients has been established, it is unknown whether CMV reactivation could affect clinical course of UC patients.…”

Section: Discussionmentioning

confidence: 99%

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Cytomegalovirus Is Frequently Reactivated and Disappears Without Antiviral Agents in Ulcerative Colitis Patients

et al. 2007

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Section: Discussionmentioning

confidence: 99%

“…In 17 patients positive for CMV Ag, the maximum value was 1 in approximately half (10,23), only one patient showed over 10 positive cells. However, the patient's symptoms improved with PSL, and CMV reactivation turned out to be negative without antiviral agents.…”

Section: The Level Of CMV Reactivationmentioning

confidence: 91%

Cytomegalovirus Is Frequently Reactivated and Disappears Without Antiviral Agents in Ulcerative Colitis Patients

et al. 2007

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“…CMV seronegative recipients were treated preemptively for the first positive antigenemia. Seropositive recipients were treated only when their antigenemia count reached a threshold of ≥10 positive cells per 400 000 leukocytes (20, 21). The height/age index as well as SBP and DBP was compared using Z‐scores according to the NCHS and the last report of the Task Force (22).…”

Section: Methodsmentioning

confidence: 99%

Early steroid withdrawal in pediatric renal transplant on newer immunosuppressive drugs

Delucchi

Valenzuela

Ferrario

et al. 2007

Pediatric Transplantation

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Steroids have been a cornerstone in renal transplant immunosuppression. New immunosuppressive drugs have led to protocols using early steroid withdrawal or complete avoidance. A prospective protocol in 23 pediatric renal transplant (ages 2-14 yr) who received decreasing steroid doses stopping at day 7 post-Tx, FK, and MMF were compared with a CsA, AZT, historically matched steroid-based control group. Basiliximab was used in two doses. Anthropometric, biochemical variables, AR rates, and CMV infection were evaluated and compared using Student's t-test and regression analysis. A better growth pattern was seen in steroid withdrawal group. GFR rate and serum glucose were similar in both groups. Total serum cholesterol levels were significantly lower in steroid withdrawal group. The incidence of AR at 12 months was 4.3% in steroid withdrawal group vs. 8.6% in steroid-based group (p = ns). No difference in CMV infection was observed. Hemoglobin levels were low during the first months in both groups; reached normal values after six months. SBP became higher at 12 months in steroid-based group. Patient and graft survival was 98% in both groups at one-yr post-transplant. Early steroid withdrawal was efficacious, safe, and did not increase risk of rejection, preserving optimal growth, renal function, and reducing cardiovascular risk factors.

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“…Antigenemia (pp65) was monitored weekly after kidney transplantation for the first 2 months and once a month thereafter. CMV seronegative recipients were treated preemptively for the first positive antigenemia and seropositive recipients were treated only when their antigenemia count reached a threshold of ten positive cells per 400,000 leukocytes [19,20]. The age-stratified height Z-score b Steroid-based control group.…”

Section: Data Collectionmentioning

confidence: 99%

Early steroid withdrawal in pediatric renal transplant: five years of follow-up

et al. 2011

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This prospective, comparative trial investigated the impact on mean change in height standard deviation score (SDS), acute rejection rate, and renal function of early steroid withdrawal in 96 recipients with 5 years of follow-up. Recipients under basiliximab induction and steroid withdrawal (SW: TAC/MMF; n = 55) were compared with a matched steroid control group (SC: TAC/MMF/STEROID, n = 41). SW received steroids until Day 6, SC decreased to 10 mg/m(2) within 2 months post-transplant. Five years after SW, the longitudinal growth (SDS) gain was 1.4 ± 0.4 vs. 1.1 ± 0.3 for SC group (p < 0.02). Height benefits in prepubertal and pubertal status in both groups were demonstrated in the delta growth trends (mixed model; p < 0.01). Biopsy-proven acute rejection in SW was 11% and 17.5%, SC (p: ns). Mean eGFR (ml/min/1.73 m(2)) at 5 years post-transplant was SW 80.6 ± 27.8 vs. 82.6 ± 25.1 for SC (p: ns). The death-censored graft survival rate at 1 and 5 years was 99 and 90% for SW; 98 and 96% for SC (p = ns). PTLD incidence in SW 3.3 vs. 2.5% in SC (p: ns). Five years post-transplant, early steroid withdrawal showed positive impacts on growth, stable renal function without increased acute rejection risk, and PTLD incidence.

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Quantitative pp65 antigenemia in the diagnosis of cytomegalovirus disease: prospective assessment in a cohort of solid organ transplant recipients

Cited by 18 publications

References 24 publications

Cytomegalovirus Is Frequently Reactivated and Disappears Without Antiviral Agents in Ulcerative Colitis Patients

Cytomegalovirus Is Frequently Reactivated and Disappears Without Antiviral Agents in Ulcerative Colitis Patients

Early steroid withdrawal in pediatric renal transplant on newer immunosuppressive drugs

Early steroid withdrawal in pediatric renal transplant: five years of follow-up

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