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Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

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Preemptive Therapy in CMV-Antigen Positive Patients after LiverTransplantation - a Prospective-Trial

Nada Rayes, Helmut Oettle, Christian A Schmidt, Rudiger Lohmann, Thomas Steinmuller, Wolf O Hechstein, Peter Neuhaus

Ann Transplant 1999; 4(2): 12-17

ID: 497447


Objective: Preemptive therapy with intravenous gannciclovir and CMV-hyperimmunoglobulin in asymptomatic CMV pp65-antigen positive patients was compared with treatment of only symptomatic CMV-disease after liver transplantation in an open prospective study. Patients and methods: 48 out of 200 liver transplant recipients became positive during six weeks follow-up after transplantation. 17out of these 48 patients who were already symptomatic at the time of positive antigen testing were successfully treated with ganciclovir and CMV-hyperimmunoglobulin. 31 asymptomatic antigen-positive pa.tients were randomised to receive preemptive therapy or to receive therapy only at onset of clinical symptoms. Results: Only two out of 15 patients in this latter grouup without preemptive therapy developed CMV-syndrome and were successfully treated with intravenous ganciclovir. 13 patients did not experience any clinicalsymptoms or disease and were therefore spared unneccessary toxicity and costs. The overall incidence of CMV-infection and -disease in the whole study population of 200 liver transplant recipients was 25% and 10%. As expected, CMV-negative patients who f2ceived an organ from a seropositive donor were at a higher risk of CMV-infection and -disease, but did not show more severe infections clinically. Patients with IL-2 receptor antibody induction therapy seemed to have a higher risk for CMV-infection and -disease.

Keywords: Liver Transplantation, CMV-infection, Preemptive Therapy

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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