title: Cytomegalovirus infection in heart-lung transplant recipients: risk factors, clinical associations, and response to treatment.
abstract: The risk factors, clinical associations, and response to treatment of cytomegalovirus (CMV) pneumonia and infection were studied in 65 recipients of heart-lung transplantation. There were 29 episodes of CMV pneumonia in 22 patients. In 80% (20/25) of episodes of CMV pneumonia treated with intravenous ganciclovir, the histologic changes resolved and the patient survived. Among seronegative recipients, a seropositive donor was a significant risk factor for CMV pneumonia and infection in the first 90 days after heart-lung transplantation (P = .004 and .002, respectively). Among seropositive recipients, there was no additional risk associated with a sero-positive donor. Rates of CMV pneumonia and infection were significantly increased when treatment with augmented immunosuppression had been given in the preceding 30 days (P less than .001). A significant association was found between CMV pneumonia or infection and pulmonary bacterial infections occurring 30 days before or after such an episode (P less than .001).
authors.affiliation: Heart-Lung Transplant Unit, Papworth Hospital, United Kingdom.
authors.forename: R L
authors.initials: RL
authors.lastname: Smyth
authors.forename: J P
authors.initials: JP
authors.lastname: Scott
authors.forename: L K
authors.initials: LK
authors.lastname: Borysiewicz
authors.forename: L D
authors.initials: LD
authors.lastname: Sharples
authors.forename: S
authors.initials: S
authors.lastname: Stewart
authors.forename: T G
authors.initials: TG
authors.lastname: Wreghitt
authors.forename: J J
authors.initials: JJ
authors.lastname: Gray
authors.forename: T W
authors.initials: TW
authors.lastname: Higenbottam
authors.forename: J
authors.initials: J
authors.lastname: Wallwork
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D001424:Bacterial Infections / Q000150:complications; D002648:Child; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D017245:Foscarnet; D015774:Ganciclovir / Q000627:therapeutic use; D016041:Heart-Lung Transplantation; D006801:Humans; D007116:Immunization, Passive; D007165:Immunosuppression Therapy; D008297:Male; D008875:Middle Aged; D010746:Phosphonoacetic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D065227:Transfusion Reaction; D014777:Virus Diseases / Q000150:complications
chemical_list: D000914:Antibodies, Viral; D017245:Foscarnet; D010746:Phosphonoacetic Acid; D015774:Ganciclovir