The impact of cytogam on cardiac transplant recipients with moderate hypogammaglobulinemia

Treatment and prevention of cytomegalovirus infection in heart and lung transplantation: an update

“…56 In this context, it should be noted that post-operative hypogammaglobulinemia, which is a common finding after thoracic transplantation, is associated with a marked increase in the risk for CMV infection, 57 and that pre-emptive CMVIG treatment in patients with moderate or severe hypogammaglobulinemia showed a trend to fewer rejection episodes in a randomized trial. 58 While it must be noted that CMVIG prophylaxis alone is not sufficient to adequately prevent CMV in heart and lung recipients, 59,60 combination therapy with (val)ganciclovir appears to provide additional benefit than antiviral therapy alone, irrespectively of the presence of hypogammaglobulinemia. With the caveat that most of this supportive evidence derives from observational and or retrospective data analyses, several observational studies have shown that CMVIG treatment in heart transplantation is associated with a significant reduction not only in CMV infection, but also in graft-related outcomes, such as acute rejection and allograft vasculopathy.…”

Cytomegalovirus infection and disease in the new era of immunosuppression following solid organ transplantation

“…A meta‐analysis was conducted to evaluate the prophylactic impact of CMV‐immune globulin, intravenous (IGIV) administration on CMV infection, disease, and mid‐term survival in kidney transplant recipients (49, 50). Results from 11 trials indicated that CMV‐IGIV is effective against CMV disease and associated death.…”

“…The efficacy of preemptive CMV‐IGIV therapy and the incidence of opportunistic infections including CMV was also evaluated in cardiac transplant patients with severe or moderate hypogammaglobulinemia (HGG) (50). Intense immunosuppressive therapy following heart transplantation is associated with severe HGG and a consequential increase in risk for rejection and opportunistic infections.…”

“…Patients with severe HGG administered preemptive CMV‐IGIV replacement therapy had fewer episodes of rejection and opportunistic infections when compared with the control group. The incidence of CMV disease in moderate HGG patients also decreased with preemptive CMV‐IGIV treatment (50).…”