Role of cytomegalovirus in cardiac allograft vasculopathy.
Cardiac allograft vasculopathy is the most common cause of death and retransplantation following heart transplantation, and about 10% of patients per year have evidence of accelerated vascular disease; 50% at 5 years. Cytomegalovirus (CMV) infection has been associated with accelerated cardiac vasculopathy and decreased 5-year survival. Prophylactic therapy using ganciclovir has reduced the incidence of CMV disease, but not in the group at highest risk, namely the seronegative recipient of an allograft from a seropositive donor (D+/R-). Combination prophylaxis consisting of CMV hyperimmune globulin (CMV-IGIV) plus ganciclovir is associated with decreased intimal thickening, reduced coronary artery disease and obliterative bronchiolitis, and improved survival.
Weill
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University of Alabama at Birmingham, USA. dweill@uab.edu
D000998:Antiviral Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000517:prevention & control* / Q000821:virology*; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000472:pathogenicity*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000517:prevention & control*; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous; D012307:Risk Factors; D014184:Transplantation, Homologous
D000998:Antiviral Agents; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; C045781:cytomegalovirus-specific hyperimmune globulin; D015774:Ganciclovir