Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation
Abstract Background Cytomegalovirus (CMV) infections after heart transplantation (HTx) can cause cardiac allograft vasculopathy. Consequently, monitoring and prophylaxis for cytomegalovirus deoxyribonucleic acid (CMV‐DNAemia) within the first weeks after HTx is recommended. Methods All patients who...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Immunity, Inflammation and Disease |
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| Online Access: | https://doi.org/10.1002/iid3.1075 |
| _version_ | 1797404107549442048 |
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| author | Moritz Benjamin Immohr Daniel Oehler Freya Sophie Jenkins Nikolas Kalampokas Vincent Hendrik Hettlich Dennis Sigetti Fabian Voß Hannan Dalyanoglu Hug Aubin Payam Akhyari Artur Lichtenberg Udo Boeken |
| author_facet | Moritz Benjamin Immohr Daniel Oehler Freya Sophie Jenkins Nikolas Kalampokas Vincent Hendrik Hettlich Dennis Sigetti Fabian Voß Hannan Dalyanoglu Hug Aubin Payam Akhyari Artur Lichtenberg Udo Boeken |
| author_sort | Moritz Benjamin Immohr |
| collection | DOAJ |
| description | Abstract Background Cytomegalovirus (CMV) infections after heart transplantation (HTx) can cause cardiac allograft vasculopathy. Consequently, monitoring and prophylaxis for cytomegalovirus deoxyribonucleic acid (CMV‐DNAemia) within the first weeks after HTx is recommended. Methods All patients who underwent HTx between September 2010 and 2021 surviving the first 90 days (n = 196) were retrospectively reviewed. The patients were divided on the prevalence of CMV‐DNAemia during the first postoperative year after the end of the prophylaxis. A total of n = 35 (20.1%) developed CMV‐DNAemia (CMV group) and were compared to patients without CMV‐DNAemia (controls, n = 139). The remaining patients (n = 22) were excluded due to incomplete data. Results Positive donors and negative recipients (D+/R−) and negative donors and positive recipients (D−/R+) serology was significantly increased and D−/R− decreased in the CMV group (p < .01). Furthermore, the mean age was 57.7 ± 8.7 years but only 53.6 ± 10.0 years for controls (p = .03). Additionally, the intensive care unit (p = .02) and total hospital stay (p = .03) after HTx were approximately 50% longer. Interestingly, the incidence of CMV‐DNAemia during prophylaxis was only numerically increased in the CMV group (5.7%, respectively, 0.7%, p = .10), the same effect was also observed for postoperative infections. Multivariate analyses confirmed that D+/R− and D−/R+ CMV immunoglobulin G match were independent risk factors for postprophylaxis CMV‐DNAemia. Conclusion Our data should raise awareness of CMV‐DNAemia after the termination of regular prophylaxis, as this affects one in five HTx patients. Especially old recipients as well as D+/R− and D−/R+ serology share an elevated risk of late CMV‐DNAemia. For these patients, prolongation, or repetition of CMV prophylaxis, including antiviral drugs and CMV immunoglobulins, may be considered. |
| first_indexed | 2024-03-09T02:50:11Z |
| format | Article |
| id | doaj.art-4fe287d4b70a484fa16ef2819a6d1472 |
| institution | Directory Open Access Journal |
| issn | 2050-4527 |
| language | English |
| last_indexed | 2024-03-09T02:50:11Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Immunity, Inflammation and Disease |
| spelling | doaj.art-4fe287d4b70a484fa16ef2819a6d14722023-12-05T11:18:03ZengWileyImmunity, Inflammation and Disease2050-45272023-11-011111n/an/a10.1002/iid3.1075Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantationMoritz Benjamin Immohr0Daniel Oehler1Freya Sophie Jenkins2Nikolas Kalampokas3Vincent Hendrik Hettlich4Dennis Sigetti5Fabian Voß6Hannan Dalyanoglu7Hug Aubin8Payam Akhyari9Artur Lichtenberg10Udo Boeken11Department of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDivision of Cardiology, Pulmonology and Angiology Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDivision of Cardiology, Pulmonology and Angiology Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyDepartment of Cardiac Surgery Medical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐University Düsseldorf Düsseldorf GermanyAbstract Background Cytomegalovirus (CMV) infections after heart transplantation (HTx) can cause cardiac allograft vasculopathy. Consequently, monitoring and prophylaxis for cytomegalovirus deoxyribonucleic acid (CMV‐DNAemia) within the first weeks after HTx is recommended. Methods All patients who underwent HTx between September 2010 and 2021 surviving the first 90 days (n = 196) were retrospectively reviewed. The patients were divided on the prevalence of CMV‐DNAemia during the first postoperative year after the end of the prophylaxis. A total of n = 35 (20.1%) developed CMV‐DNAemia (CMV group) and were compared to patients without CMV‐DNAemia (controls, n = 139). The remaining patients (n = 22) were excluded due to incomplete data. Results Positive donors and negative recipients (D+/R−) and negative donors and positive recipients (D−/R+) serology was significantly increased and D−/R− decreased in the CMV group (p < .01). Furthermore, the mean age was 57.7 ± 8.7 years but only 53.6 ± 10.0 years for controls (p = .03). Additionally, the intensive care unit (p = .02) and total hospital stay (p = .03) after HTx were approximately 50% longer. Interestingly, the incidence of CMV‐DNAemia during prophylaxis was only numerically increased in the CMV group (5.7%, respectively, 0.7%, p = .10), the same effect was also observed for postoperative infections. Multivariate analyses confirmed that D+/R− and D−/R+ CMV immunoglobulin G match were independent risk factors for postprophylaxis CMV‐DNAemia. Conclusion Our data should raise awareness of CMV‐DNAemia after the termination of regular prophylaxis, as this affects one in five HTx patients. Especially old recipients as well as D+/R− and D−/R+ serology share an elevated risk of late CMV‐DNAemia. For these patients, prolongation, or repetition of CMV prophylaxis, including antiviral drugs and CMV immunoglobulins, may be considered.https://doi.org/10.1002/iid3.1075cardiac allograft vasculopathycytomegalovirusheart transplantationprophylaxis |
| spellingShingle | Moritz Benjamin Immohr Daniel Oehler Freya Sophie Jenkins Nikolas Kalampokas Vincent Hendrik Hettlich Dennis Sigetti Fabian Voß Hannan Dalyanoglu Hug Aubin Payam Akhyari Artur Lichtenberg Udo Boeken Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation Immunity, Inflammation and Disease cardiac allograft vasculopathy cytomegalovirus heart transplantation prophylaxis |
| title | Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation |
| title_full | Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation |
| title_fullStr | Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation |
| title_full_unstemmed | Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation |
| title_short | Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation |
| title_sort | evaluation of risk factors for cytomegalovirus dnaemia after end of regular prophylaxis after heart transplantation |
| topic | cardiac allograft vasculopathy cytomegalovirus heart transplantation prophylaxis |
| url | https://doi.org/10.1002/iid3.1075 |
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