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Antiviral prophylaxis versus preemptive therapy to prevent cytomegalovirus infection and related death in liver transplantation: a retrospective study with propensity score matching

Authors
 S.I. Kim  ;  C.J. Kim  ;  M.W. Kang  ;  D.G. Kim  ;  Y.K. You  ;  J.I. Kim  ;  S. Hwang  ;  M.S. Kim  ;  Y.E. Kim  ;  H. Son  ;  Y.J. Kim 
Citation
 Transplantation Proceedings, Vol.44(3) : 787-790, 2012 
Journal Title
 Transplantation Proceedings 
ISSN
 0041-1345 
Issue Date
2012
Abstract
BACKGROUND: Cytomegalovirus (CMV), the most significant viral infection in liver transplant recipients, is addressed by 2 methods: Preemptive therapy (PT) or universal prophylaxis (UP). METHODS: We analyzed medical records including at least 1 year follow-up of patients who underwent liver transplantation from 2006 to 2009 in 3 tertiary hospitals. PT was used in 2 hospitals (PT group), whereas UP with valganciclovir for 3 months was adopted in the other hospital (UP group). The 2 groups were matched using propensity scoring by perioperative variables. We performed a 1:1 comparison of the efficacy of UP and PT. RESULTS: We analyzed 634 liver transplant patients, including 562 matched subjects. Baseline characteristics and underlying liver status were comparable. CMV immunoglobulin G of recipients was positive in 98.9% of the PT group and 99.3% of the UP group. CMV viremia episodes that required administration of an antiviral agent occurred in 26 (9.3%) PT and 37 (13.2%) UP subjects (P = .18). CMV-related mortalities were similar (0.7% vs 1.8%; P = .45), but all-cause mortality was higher in the PT group (18.5% vs 13.2%; P = .08). CONCLUSION: The efficacy of PT was similar to UP to prevent CMV disease and related mortality among a group at moderate risk for CMV infection.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91967
DOI
10.1016/j.transproceed.2012.01.073
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김명수(Kim, Myoung Soo)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0041134512001078
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