title: Cytomegalovirus Treatment Strategy After a Liver Transplant: Preemptive Therapy or Prophylaxis for Cytomegalovirus Seropositive Donor and Recipient.
abstract: OBJECTIVE
  Cytomegalovirus infections cause the most frequent infection after solid-organ transplant. While Cytomegalovirus prophylaxis is established in high-risk patients (donor+/ recipient-), data on Cytomegalovirus prophylaxis in other serostatus constellation are rare. The aim of this study was to evaluate the influence of Cytomegalovirus treatment strategy after a liver transplant (preemptive therapy vs general prophylaxis) in the largest group of patients: Cytomegalovirus seropositive donor and recipient.
  
  
  METHODS
  Forty-seven seropositive recipients of seropositive donor liver transplants (D+/R+, 2005-2012) were included in this retrospective study. Twenty-one patients received oral valganciclovir as Cytomegalovirus prophylaxis 100 days after transplant. Cytomegalovirus infection and Cytomegalovirus disease were monitored during the first 6 months.
  
  
  RESULTS
  A Cytomegalovirus infection could be detected in 4 out of 47 patients (8.5%), including Cytomegalovirus disease in 2 patients (Cytomegalovirus pneumonia and Cytomegalovirus-CNS disease). Three of these patients received no Cytomegalovirus prophylaxis (P = .408). Eight patients developed a graft failure; this occurred more frequently among patients without Cytomegalovirus prophylaxis (P = .044). Patients receiving Cytomegalovirus prophylaxis more often developed leukopenia. No difference was seen regarding the number of platelets, hemoglobin, and creatinine.
  
  
  CONCLUSIONS
  Cytomegalovirus prophylaxis can minimize the risk of Cytomegalovirus reactivation and graft failure. However, disadvantages of the prophylaxis as leukopenia should be considered.
authors: From the Department of General and Visceral Surgery, Muenster University Hospital, Waldeyerstr. 1, 48149 Muenster, Germany.
authors: Kirsten
authors: K
authors: Lindner
authors: Christoph
authors: C
authors: Anthoni
authors: Susanne
authors: S
authors: Beckebaum
authors: Norbert
authors: N
authors: Senninger
authors: Jens Peter
authors: JP
authors: Hölzen
authors: Heiner
authors: H
authors: Wolters
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D003587:Cytomegalovirus / Q000187:drug effects* / Q000276:immunology / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D016208:Databases, Factual; D004334:Drug Administration Schedule; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000077562:Valganciclovir; D014775:Virus Activation / Q000187:drug effects; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D015415:Biomarkers; D000077562:Valganciclovir; D015774:Ganciclovir