The Journal of Heart and Lung Transplantation
Volume 27, Issue 5 , Pages 536-539 , May 2008

High Incidence of Cytomegalovirus Disease in D+/R− Heart Transplant Recipients Shortly After Completion of 3 Months of Valganciclovir Prophylaxis

  • Sachin Gupta, MD

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
    • ,
  • Joshua D. Mitchell, BS

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
    • ,
  • David W. Markham, MD

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
    • ,
  • Pradeep P.A. Mammen, MD

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
    • ,
  • Parag C. Patel, MD

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
    • ,
  • Patricia Kaiser, RN

      Affiliations

    • Cardiac Transplant Program, University Hospital–St. Paul, University of Texas Southwestern Medical Center, Dallas, Texas
    • ,
  • W. Steves Ring, MD

      Affiliations

    • Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
    • ,
  • J. Michael DiMaio, MD

      Affiliations

    • Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
    • ,
  • Mark H. Drazner, MD, MSc

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
    • Corresponding Author InformationReprint requests: Mark H. Drazner, MD, MSc, Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9047. Telephone: 214-645-7500. Fax: 214-645-7501.

Received 26 November 2007 ,Revised 29 January 2008 ,Accepted 6 February 2008.

References 

  1. Valantine HA, Gao SZ, Menon SG, et al. Impact of prophylactic immediate posttransplant ganciclovir on development of transplant atherosclerosis: a post hoc analysis of a randomized, placebo-controlled study. Circulation. 1999;100:61–66
  2. Hart GD, Paya CV. Prophylaxis for CMV should now replace pre-emptive therapy in solid organ transplantation. Rev Med Virol. 2001;11:73–81
  3. Singh N. Delayed occurrence of cytomegalovirus disease in organ transplant recipients receiving antiviral prophylaxis: are we winning the battle only to lose the war?. Eur J Clin Microbiol Infect Dis. 2002;21:643–646
  4. Devyatko E, Zuckermann A, Ruzicka M, et al. Pre-emptive treatment with oral valganciclovir in management of CMV infection after cardiac transplantation. J Heart Lung Transplant. 2004;23:1277–1282
  5. Vrtovec B, Thomas CD, Radovancevic R, Frazier OH, Radovancevic B. Comparison of intravenous ganciclovir and cytomegalovirus hyperimmune globulin pre-emptive treatment in cytomegalovirus-positive heart transplant recipients. J Heart Lung Transplant. 2004;23:461–465
  6. Zamora MR, Nicolls MR, Hodges TN, et al. Following universal prophylaxis with intravenous ganciclovir and cytomegalovirus immune globulin, valganciclovir is safe and effective for prevention of CMV infection following lung transplantation. Am J Transplant. 2004;4:1635–1642
  7. Doyle AM, Warburton KM, Goral S, et al. 24-week oral ganciclovir prophylaxis in kidney recipients is associated with reduced symptomatic cytomegalovirus disease compared to a 12-week course. Transplantation. 2006;81:1106–1111
  8. Preiksaitis JK, Brennan DC, Fishman J, Allen U. Canadian society of transplantation consensus workshop on cytomegalovirus management in solid organ transplantation final report. Am J Transplant. 2005;5:218–227
  9. Rosenberg PB, Vriesendorp AE, Drazner MH, et al. Induction therapy with basiliximab allows delayed initiation of cyclosporine and preserves renal function after cardiac transplantation. J Heart Lung Transplant. 2005;24:1327–1331
  10. Potena L, Holweg CT, Chin C, et al. Acute rejection and cardiac allograft vascular disease is reduced by suppression of subclinical cytomegalovirus infection. Transplantation. 2006;82:398–405
  11. Potena L, Holweg CT, Vana ML, et al. Frequent occult infection with cytomegalovirus in cardiac transplant recipients despite antiviral prophylaxis. J Clin Microbiol. 2007;45:1804–1810
  12. Kijpittayarit-Arthurs S, Eid AJ, Kremers WK, et al. Clinical features and outcomes of delayed-onset primary cytomegalovirus disease in cardiac transplant recipients. J Heart Lung Transplant. 2007;26:1019–1024
  13. Carrier M, Leblanc MH, Perrault LP, et al. Basiliximab and rabbit anti-thymocyte globulin for prophylaxis of acute rejection after heart transplantation: a non-inferiority trial. J Heart Lung Transplant. 2007;26:258–263
  14. Boucher A, Lord H, Collette S, Morin M, Dandavino R. Cytomegalovirus infection in kidney transplant recipients: evolution of approach through three eras. Transplant Proc. 2006;38:3506–3508

PII: S1053-2498(08)00135-6

doi: 10.1016/j.healun.2008.02.002

The Journal of Heart and Lung Transplantation
Volume 27, Issue 5 , Pages 536-539 , May 2008

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