Incidence, risk factors, and outcomes associated with cytomegalovirus disease in small bowel transplant recipients

Diana F Florescu, Alan Norman Langnas, W. Grant, David F Mercer, J. Botha, F. Qiu, L. Shafer, Andre C Kalil

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Despite improved prophylaxis, monitoring, and more efficient immunosuppression, CMV infection remains a common opportunistic infection in transplant recipients. We assessed the incidence of CMV disease in pediatric SBT recipients, the timing of CMV disease after transplantation, and its impact on patient outcome. The medical records of 98 SBT recipients were reviewed. We performed descriptive analysis, regression analysis, and Kaplan-Meier curves to determine the time-to-event after transplantation. Fifty-three percent patients were male and 47% female, with a mean age of 38.3 months. Thirty-five percent of patients received prophylactic VGC, 55% GCV, 10% a combination of GCV/VGC, and 99% CMV immunoglobulins. A total of 24.5% recipients were CMV D+/R- (CMV serostatus donor positive/recipient negative). Seven (c. 7%) patients developed CMV disease. CMV disease was associated with 2.5 times (0.52-12.1; p = 0.25) higher rate of CMV mismatch and 11.1 times (1.3-95.9; p = 0.03) higher risk of death. CMV prophylaxis increased time-to-death (p = 0.074). Time-to-CMV disease was shorter in patients with enteritis (p < 0.0001), and CMV disease was associated with shorter time-to-death after transplantation (p = 0.001). CMV disease in SBT recipients was associated with an 11-fold mortality increase and a fourfold faster time-to-death. Time-to-death was significantly shorter with CMV enteritis.

Original languageEnglish (US)
Pages (from-to)294-301
Number of pages8
JournalPediatric Transplantation
Volume16
Issue number3
DOIs
StatePublished - May 1 2012

Fingerprint

Cytomegalovirus
Incidence
Enteritis
Transplantation
Opportunistic Infections
Transplant Recipients
Immunosuppression
Medical Records
Immunoglobulins
Regression Analysis
Tissue Donors
Pediatrics
Mortality
Infection

Keywords

  • cytomegalovirus
  • disease
  • infection
  • intestinal transplantation
  • pediatric
  • small bowel transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Incidence, risk factors, and outcomes associated with cytomegalovirus disease in small bowel transplant recipients. / Florescu, Diana F; Langnas, Alan Norman; Grant, W.; Mercer, David F; Botha, J.; Qiu, F.; Shafer, L.; Kalil, Andre C.

In: Pediatric Transplantation, Vol. 16, No. 3, 01.05.2012, p. 294-301.

Research output: Contribution to journalArticle

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