An international survey of cytomegalovirus prevention and treatment practices in intestinal transplantation

Diana F. Florescu, Kareem Abu-Elmagd, David F. Mercer, Fang Qiu, Andre C. Kalil

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background: Practice variation regarding cytomegalovirus (CMV) prevention and treatment across intestinal transplantation (IT) programs is unknown. Methods: An electronic survey was sent to IT programs registered with the Intestinal Transplant Association. Proportions were analyzed for categorical variables; means and SDs were analyzed for continuous variables. Results: Seventy-seven percent of IT programs responded to the survey. For CMV D+/R-recipients, 39.1% programs used universal prophylaxis (UP), 8.7% preemptive strategy (PE), and 52.2% hybrid strategy. For CMV R+ recipients, 45.8% programs used UP, 12.5% PE, 37.1% hybrid strategy, and 4.2% none. For CMV D-/R-recipients, 39.1% programs used UP, 21.7% PE, 26.1% hybrid strategy, and 13% none. Frequency of monitoring for PE was weekly 71.4% of programs, every 2 weeks 21.4%, and monthly 7.1%. For CMV viremia, syndrome and disease, the most common first-line agents used were ganciclovir (100% and 96.2%) and valganciclovir (23.1%) and the second-line agent was foscarnet (73.1% and 84.6%). Immunoglobulins were administered in 65.4% of the programs for pneumonia (69.2%), meningoencephalitis (50%), enteritis (46.2%), colitis (38.5%), syndrome (42.3%), viremia (30.8%), and resistant/refractory infections (11.5%). Conclusions: Prophylaxis and hybrid strategy were the most commonly used. Treatment practices were consistent and mainly involved ganciclovir as first-line agent and foscarnet as second-line agent. The use of immunoglobulins appeared to be more common than in other allografts.

Original languageEnglish (US)
Pages (from-to)78-82
Number of pages5
JournalTransplantation
Volume97
Issue number1
DOIs
StatePublished - Jan 15 2014

Keywords

  • Cytomegalovirus (CMV)
  • Intestinal
  • Preemptive
  • Prophylaxis
  • Small bowel
  • Transplant
  • Treatment

ASJC Scopus subject areas

  • Transplantation

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