This work was presented in part as an oral abstract at American Transplant Congress Twelfth Joint Annual Meeting, June 2–6, 2012, Boston, MA.
Late-Onset Cytomegalovirus (CMV) in Lung Transplant Recipients: Can CMV Serostatus Guide the Duration of Prophylaxis?
Article first published online: 3 DEC 2012
© 2012 American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 13, Issue 2, pages 376–382, February 2013
How to Cite
Schoeppler, K. E., Lyu, D. M., Grazia, T. J., Crossno, J. T., Vandervest, K. M. and Zamora, M. R. (2013), Late-Onset Cytomegalovirus (CMV) in Lung Transplant Recipients: Can CMV Serostatus Guide the Duration of Prophylaxis?. American Journal of Transplantation, 13: 376–382. doi: 10.1111/j.1600-6143.2012.04339.x
- Issue published online: 28 JAN 2013
- Article first published online: 3 DEC 2012
- Manuscript Accepted: 14 OCT 2012
- Manuscript Revised: 28 SEP 2012
- Manuscript Received: 26 JUN 2012
- Acute rejection;
- cytomegalovirus (CMV);
- lung transplant;
Evidence supports the use of 12 months of cytomegalovirus prophylaxis in all at-risk lung transplants; whether cytomegalovirus serostatus can be used to further optimize this duration remains to be determined. The purpose of this retrospective study was to determine if cytomegalovirus serostatus of both donor and recipient were associated with late-onset cytomegalovirus. The primary outcome was the proportion of lung transplants that developed cytomegalovirus infection or disease during the 180-day period following 6 months of prophylaxis in each at-risk serotype. Two hundred forty-four consecutive lung transplants were evaluated, 131 were included. The proportion of recipients with cytomegalovirus differed significantly between serotypes (20 of 41 [48.8%] D+/R- vs. 19 of 56 [33.9%] D+/R+ vs. 2 of 34 [5.9%] D-/R+; p < 0.001). In a multivariate model, older age (odds ratio [OR], 1.05, 95% confidence interval [CI] 1.004–1.099; p = 0.03) and D+/R- serostatus (OR, 3.83; 95% CI 1.674–8.770; p = 0.002) were associated with cytomegalovirus. Among R+ lung transplants, D- serostatus was associated with the absence of cytomegalovirus (OR, 0.12; 95% CI 0.0263–0.563; p = 0.007). These findings suggest that in the valganciclovir era, cytomegalovirus serostatus of both donor and recipient may identify lung transplants at heightened risk for late-onset cytomegalovirus.