July 9, 2012

Cytomegalovirus Replication Kinetics in Solid Organ Transplant Recipients Managed by Preemptive Therapy


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Many transplant centers use CMV prophylaxis in CMV mismatched patients. However, this study examined a large cohort of CMV D+/R- or R+ liver and kidney patients who were all managed with pre-emptive therapy. CMV syndrome occurred in approximately one-third of transplant patients that were D+/R- and in a greater proportion of those who had liver (compared to kindey) transplants. ¾However, doubling time was equal in both types of transplants. D+/R- kidney patients were more likely to have a second viremic episode. Interestingly, 30% of D+/R- patients in the cohort were able to control viremia such that they did not require antiviral therapy. This study suggests that there is a subset of D+/R- patients that are able to control viremia and may not require primary prophylaxis. Future studies that determine which patients fall into this group and have appropriate immune control are needed.

Transplant Infectious Disease

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