Journal article
CMV infection and management among pediatric solid organ transplant recipients
Pediatric transplantation, v 26(3), pp e14220-n/a
May 2022
PMID: 34994041
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Cytomegalovirus (CMV) is an important cause of morbidity and mortality in pediatric solid organ transplant (SOT) recipients. However, the impact of asymptomatic CMV infections (ie, DNAemia) on clinical outcomes is not well established.
We performed a retrospective cohort study of children undergoing first SOT at our institution from January 2012 to June 2018. We evaluated the epidemiology of CMV infections and performed multivariable Cox regression to assess the association between CMV DNAemia without disease or CMV disease (syndrome or end-organ disease) on negative outcomes (death, re-transplantation, or moderate/severe rejection) within the first year after SOT.
Among 271 individuals, 43 (15.9%) developed ≥1 CMV infection during the first year after SOT. There were 56 unique CMV infections including 14 episodes of CMV disease. In 167 patients offered CMV prophylaxis, only 8 (4.8%) developed their first CMV DNAemia episode while on prophylaxis 32 developed CMV DNAemia after prophylaxis completion; only 1 episode of CMV disease occurred while on antiviral prophylaxis. When accounting for receipt of ATG, oral steroids, and number of immunosuppressives on a given day, CMV disease was more strongly associated with negative outcomes (Hazard Ratio (HR): 3.28, 95% CI: 0.73-14.64; p = .12) than CMV DNAemia without disease (HR 1.42, 95% CI: 0.19- 10.79; p = .74), although not to a statistically significant degree.
Most CMV infections occurred after completion of antiviral prophylaxis. CMV disease was more strongly associated with negative outcomes than asymptomatic CMV DNAemia and should be the focus of CMV prevention practices.
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Details
- Title
- CMV infection and management among pediatric solid organ transplant recipients
- Creators
- Kevin J Downes - University of PennsylvaniaAnna Sharova - Children's Hospital of PhiladelphiaCraig L K Boge - Children's Hospital of PhiladelphiaDaniel Vader - University of PennsylvaniaMarina Mitrou - Children's Hospital of PhiladelphiaMolly Hayes - Children's Hospital of PhiladelphiaDespoina M Galetaki - Children's Hospital of PhiladelphiaLauren Gianchetti - Children's Hospital of PhiladelphiaLaura A Vella - University of PennsylvaniaYun Li - University of Pennsylvania
- Publication Details
- Pediatric transplantation, v 26(3), pp e14220-n/a
- Publisher
- Wiley
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000739705500001
- Scopus ID
- 2-s2.0-85122398725
- Other Identifier
- 991021965367204721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Pediatrics
- Transplantation