Association of Cytomegalovirus Infection and Disease With Death and Graft Loss After Liver Transplant in High-Risk Recipients

被引:42
作者
Bosch, W. [1 ]
Heckman, M. G. [2 ]
Diehl, N. N. [2 ]
Shalev, J. A. [3 ]
Pungpapong, S. [4 ]
Hellinger, W. C. [1 ]
机构
[1] Mayo Clin Florida, Div Infect Dis, Jacksonville, FL USA
[2] Mayo Clin Florida, Div Biostat, Jacksonville, FL USA
[3] Mayo Clin Florida, Div Transplant, Jacksonville, FL USA
[4] Mayo Clin Florida, Div Liver Transplant, Jacksonville, FL USA
关键词
Cytomegalovirus (CMV); death; graft failure; graft loss; liver transplantation; mortality; ORAL GANCICLOVIR; ANTIVIRAL PROPHYLAXIS; VALGANCICLOVIR; EFFICACY; SAFETY; IMPACT; PREVENTION; STRATEGIES; TRIAL;
D O I
10.1111/j.1600-6143.2011.03618.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
In the era of effective antiviral chemoprophylaxis, cytomegalovirus (CMV) disease has been inconsistently associated with increased mortality in liver transplant (LT) recipients. A retrospective study evaluating the association of CMV infection and disease occurring within 1 year of transplant with the endpoints of death or the combined endpoint of graft loss or death was undertaken in a cohort of 227 CMV donor seropositive, recipient seronegative first LT recipients. Associations were evaluated using Cox proportional hazards regression models. CMV infection and disease occurred in 91 (40%) and 43 (19%) patients, respectively. Forty-eight (21%) died while 58 (26%) sustained graft loss or death. In multivariable analysis, CMV infection was associated with an increased risk of death (RR: 2.24, p = 0.008) and graft loss or death (RR: 2.85, p < 0.001). CMV disease was also associated with an increased risk of death (RR: 2.73, p = 0.003) and graft loss or death (RR: 3.04, p = 0.001). CMV infection and disease occurring within the first year after LT in high-risk recipients is associated with increased risk of death and of graft loss or death. Investigation of strategies to further reduce the risk of CMV infection and disease in high-risk LT recipients is warranted.
引用
收藏
页码:2181 / 2189
页数:9
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