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Evaluation of two different CMV-immunoglobulin regimens for combined CMV prophylaxis in high-risk patients following lung transplant

Abstract: Background: The clinical benefits of the common off-label use of cytomegalovirus (CMV)-specific immunoglobulin (CMV-Ig) combined with antivirals in organ transplantation have not been previously assessed. The objective was to compare the risk of CMV infection and other post-transplantation outcomes between two CMV-Ig prophylaxis regimens in lung transplant recipients; Methods: Retrospective study of 124 donor CMV positive/recipient negative (D+/R?) patients receiving preventive ganciclovir/valganciclovir for 12 months, of whom 62 received adjunctive CMV-Ig as per label indication (short regimen [SR-Ig]; i.e., 7 doses over 2.5 months) and were compared to 62 who received an extended off-label regimen (ER-Ig) consisting of 17 doses over one year after transplantation. Results: The incidence of CMV infection or disease, acute rejection, chronic lung allograft dysfunction, and survival did not differ between the two CMV-Ig schedules. Although the time to the first CMV infection after transplantation was shorter in the ER-Ig than in the SR-Ig adjunctive group (log-rank: p = 0.002), the risk was independently predicted by antiviral cessation (odds ratio = 3.74; 95% confidence interval = 1.04?13.51; p = 0.030), whereas the CMV-Ig schedule had no effect. Conclusions: Extending the adjunctive CMV-Ig prophylaxis beyond the manufacturer's recommendations up to one year does not confer additional clinical benefits regarding lung post-transplantation outcomes.

 Fuente: Microorganisms, 2023, 11, 32

Editorial: MDPI

 Año de publicación: 2023

Nº de páginas: 14

Tipo de publicación: Artículo de Revista

 DOI: 10.3390/microorganisms11010032

ISSN: 2076-2607

Url de la publicación: https://doi.org/10.3390/microorganisms11010032

Autoría

VÍCTOR MANUEL MORA CUESTA

USSETTI, PIEDAD

PABLO, ALICIA DE

DAVID ITURBE FERNANDEZ

LAPORTA, ROSALÍA

ALONSO, RODRIGO

AGUILAR, MYRIAM

QUEZADA, CARLOS A.