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Risk Factors for Cytomegalovirus Reactivation in Lung Transplant Recipients

Authors
 Se Hyun Kwak  ;  Su Hwan Lee  ;  Moo Suk Park  ;  Su Jin Jeong  ;  Jin Gu Lee  ;  Hyo Chae Paik  ;  Young Sam Kim  ;  Joon Chang  ;  Song Yee Kim 
Citation
 LUNG, Vol.198(5) : 829-838, 2020-10 
Journal Title
 LUNG 
ISSN
 0341-2040 
Issue Date
2020-10
Keywords
Cytomegalovirus ; Pulmonary disease ; Reactivation ; Risk factors ; Transplantation
Abstract
Purpose: We examined risk factors that may have contributed to Cytomegalovirus (CMV) reactivation among patients who underwent lung transplantation (LTx). Methods: We reviewed medical records of patients who underwent LTx at a tertiary healthcare hospital in South Korea between January 2013 and May 2017. We excluded patients who died within the first year after LTx and those lost to follow-up. CMV reactivation was defined as the detection of CMV titers above 3000 copies/ml regardless of specific symptoms after prophylaxis cessation. Results: Of 89 patients included, 39 (43.8%) developed CMV reactivation. Of those 39 patients, 16 (41.0%) experienced additional CMV reactivation. Multivariate analysis identified lymphocyte counts below 1.0 × 103/μl (hazard ratio [HR] 49.33, p < 0.001) and use of steroids at more than twice the standard dose (HR 8.07, p < 0.001) as risk factors for CMV reactivation. The multivariate model also identified chronic kidney disease (CKD; HR 5.19, p = 0.016) and pneumonia (HR 17.22, p = 0.013) as risk factors for repetitive CMV reactivation. Conclusion: This study suggests that lymphopenia and high doses of steroids may be important risk factors for CMV reactivation in LTx patients. Our results also suggest that repetitive CMV reactivation may be associated with CKD and pneumonia.
Full Text
https://link.springer.com/article/10.1007%2Fs00408-020-00380-z
DOI
10.1007/s00408-020-00380-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
Lee, Jin Gu(이진구)
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180372
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