Cytomegalovirus Immunoglobulin Decreases the Risk of Cytomegalovirus Infection but not Disease After Pediatric Lung Transplantation

Kavitha Ranganathan, Sarah Worley, Marian G. Michaels, Susana Arrigan, Paul Aurora, Manfred Ballmann, Debra Boyer, Carol Conrad, Irmgard Eichler, Okan Elidemir, Samuel Goldfarb, George B. Mallory, Peter J. Mogayzel, Daiva Parakininkas, Melinda Solomon, Gary Visner, Stuart C. Sweet, Albert Faro, Lara Danziger-Isakov

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Cytomegalovirus (CMV) has been associated with morbidity, including chronic allograft rejection, in transplant recipients. Data from adult centers suggests that CMV hyperimmune globulin (CMVIG) and ganciclovir together are superior in preventing CMV viremia than ganciclovir alone. Methods: A retrospective review of pediatric lung transplant recipients at 14 sites in North America and Europe was conducted to evaluate the effect of adding cytomegalovirus immunoglobulin (CMVIG) prophylaxis to at least 3 weeks of intravenous ganciclovir therapy in pediatric lung transplant recipients. Data were recorded for the first year after transplantation. Associations between time to CMV and risk factors, including CMVIG use, were assessed by multivariable Cox proportional hazards models. Results: Of 599 patients whose records were reviewed, 329 received at least 3 weeks of ganciclovir, with 62 (19%) receiving CMVIG. CMVIG was administered more frequently with CMV donor-positive/recipient-negative serostatus (p < 0.05). In multivariable models, patients who did not receive CMVIG as part of their prophylaxis were 3 times more likely to develop CMV infection (hazard ratio, 3.4; 95% confidence interval, 1.2-9.5) independent of CMV serostatus. However, CMVIG administration was not associated with decreased risk of episodes of CMV disease. Receipt of CMVIG was not associated with decreased risks of post-transplant morbidities (acute rejection, respiratory viral infection or early bronchiolitis obliterans) or morbidity within the first year after pediatric lung transplantation. Conclusion: The use of CMVIG in addition to antiviral prophylaxis in pediatric lung transplantation requires further evaluation.

Original languageEnglish (US)
Pages (from-to)1050-1056
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume28
Issue number10
DOIs
StatePublished - Oct 2009

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Fingerprint Dive into the research topics of 'Cytomegalovirus Immunoglobulin Decreases the Risk of Cytomegalovirus Infection but not Disease After Pediatric Lung Transplantation'. Together they form a unique fingerprint.

Cite this