Risk of cytomegalovirus infection and subsequent allograft failure after pancreas transplantation

Yetmar, Zachary A.; Kudva, Yogish C.; Seville, Maria Teresa; Bosch, Wendelyn; Huskey, Janna L.; Jarmi, Tambi; Kukla, Aleksandra; Dean, Patrick G.; Razonable, Raymund R.; Beam, Elena

doi:10.1016/j.ajt.2023.10.007

Cited by 2 publications

(1 citation statement)

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“…In previous studies, the frequency of CMV infections among the CMV D+/R− SPK patients has been between 20%–60%, and similarly as after all solid organ transplants, CMV D+/R− patients are at highest risk of developing CMV viremia ( 12 – 14 ). A recent study described cumulative rates of clinically significant CMV infection to be 54.0% in D+/R− and 15.8% in R+ patient populations ( 15 ). The difference in prevalence compared to our study is likely due to us reporting CMV DNAemia and the other study reporting clinically significant CMV infections defined as either symptomatic disease or one needing antiviral treatment.…”

Section: Discussionmentioning

confidence: 99%

High burden of CMV infections after simultaneous pancreas-kidney transplantation—a nationwide cohort study

Ahopelto,

Grasberger,

Ortiz

et al. 2024

Front. Transplant.

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Cytomegalovirus (CMV) infections remain a common problem after solid-organ transplantation. We characterized the burden of CMV infections, and adverse events of CMV prophylaxis after simultaneous pancreas-kidney transplantation (SPK). We included all SPK patients (n = 236) since 2010 in our country. Immunosuppression was ATG, tacrolimus, mycophenolate, and steroids. Valganciclovir prophylaxis was given to all CMV D+/R− patients for six months, and to seropositive SPK patients for three months since February 2019. CMV DNAemia was monitored with quantitative PCR from plasma. Among D+/R− SPK recipients, post prophylaxis CMV infection was detected in 41/60 (68%) during follow-up. In seropositive SPK recipients with no prophylaxis, CMV infection was detected in 53/95 (56%), vs. 28/78 (36%) in those who received 3 months of prophylaxis (P = 0.01). CMV was symptomatic in 35 (15%) patients, of which 10 required hospitalization. Mean duration of viremia was 28 days (IQR 21–41). Leukopenia was detected in 63 (46%) of the 138 patients with valganciclovir prophylaxis. 7/122 (6%) of the CMV infections detected were defined as refractory to treatment, and three patients had confirmed ganciclovir resistance. SPK recipients experience a high burden of CMV infections despite CMV prophylaxis. Leukopenia is common during valganciclovir prophylaxis.

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Section: Discussionmentioning

confidence: 99%