The Effects of Preemptive Therapy Using a Very Low Threshold of pp65 Antigenemia to Prevent Cytomegalovirus Disease in Kidney Transplant Recipients: A Single-Center Experience

Saracino, A.; Colucci, R.; Latorraca, Angela; Muscaridola, N.; Procida, C.; Noia, I. Di; Santospirito, Vincenzo; Santarsia, G.

doi:10.1016/j.transproceed.2012.07.144

Cited by 4 publications

(3 citation statements)

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“…The median age of patients who had infection was higher than those who did not have infection (39 vs. 17 years). In other studies, there was no association between patient age and occurrence of active infection [ 3 13 ]. Other factors evaluated, such as sex, serostatus profile of the donor/recipient, use of anti-thymocyte globulin, and type of immunosuppressive therapy, did not influence the occurrence of infection.…”

Section: Discussionmentioning

confidence: 86%

“…Saracino et al, suggested that antigenemia ≥2 positive cells/200,000 leukocytes can be considered an appropriate cutoff point for starting pre-emptive therapy among renal transplant recipients [ 13 ]. In contrast, Jung et al, concluded that the therapy should be administered only to patients with ≥25 positive cells per slide [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Under the pre-emptive therapy guidelines, treatment is continued until two consecutive negative antigenemia assay results are obtained. Patients with CMV infection should receive intravenous ganciclovir or oral valganciclovir for a minimum of 14 days until resolution of symptoms [ 12 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Cytomegalovirus Infection after Renal Transplantation: Occurrence, Clinical Features, and the Cutoff for Antigenemia in a University Hospital in Brazil

2017

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BackgroundCytomegalovirus (CMV) is the main infectious agent causative of morbidity and mortality in transplant recipients. This study aimed to describe the occurrence and clinical features of CMV infection, and the optimum antigenemia assay cutoff associated with symptomatic infection.Materials and MethodsThis was a cohort study that investigated 87 patients undergoing renal transplantation. The patients were monitored with the CMV antigenemia assay performed weekly for the first 3 months post-transplantation and subsequently, when CMV infection was suspected clinically.ResultsCMV infection was observed in 63.2% (55/87) of the recipients during the follow-up. Of the 65 episodes observed, 75% (49/65) occurred until 100 days after transplantation (D+100) and 25% (16/65) after D+100 with a median of 60 days. CMV infection was associated with age of the transplant recipients (P = 0.001) and use of deceased donor organ (P = 0.009). There were asymptomatic (34%) and symptomatic (66%) episodes of CMV infection, in which diarrhea was the most common symptom (22.6%), followed by elevated creatinine levels (14.5%), fever (12.9%) and leukopenia (10.5%). The optimum cutoff point associated with symptomatic infection was 5 positive cells/200,000 leukocytes (area under the curve = 0.87, positive predictive value = 88% and negative predictive value= 71%).ConclusionsThe high occurrence and the risk factors for CMV infection such as the age of recipients, the number of positive cells in the antigenemia assay, and use of a deceased donor organ should be considered for appropriate monitoring and management of kidney recipients during the post-transplant period.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%