Cytomegalovirus Infections in Lung and Hematopoietic Cell Transplant Recipients in the Organ Transplant Infection Prevention and Detection (OTIP) Study: a Multi-Year, Multi-Center Prospective Cohort Study

Avery, Robin K, Silveira, Fernanda P, Benedict, Kaitlin, Cleveland, Angela Ahlquist, Kauffman, Carol A, Schuster, Mindy G, Dubberke, Erik R, Husain, Shahid, Paterson, David, Chiller, Tom and Pappas, Peter (2018) Cytomegalovirus Infections in Lung and Hematopoietic Cell Transplant Recipients in the Organ Transplant Infection Prevention and Detection (OTIP) Study: a Multi-Year, Multi-Center Prospective Cohort Study. Transplant Infectious Disease , e12877. doi:10.1111/tid.12877


Author Avery, Robin K
Silveira, Fernanda P
Benedict, Kaitlin
Cleveland, Angela Ahlquist
Kauffman, Carol A
Schuster, Mindy G
Dubberke, Erik R
Husain, Shahid
Paterson, David
Chiller, Tom
Pappas, Peter
Title Cytomegalovirus Infections in Lung and Hematopoietic Cell Transplant Recipients in the Organ Transplant Infection Prevention and Detection (OTIP) Study: a Multi-Year, Multi-Center Prospective Cohort Study
Journal name Transplant Infectious Disease    Check publisher's open access policy
ISSN 1399-3062
1398-2273
Publication date 2018-03-07
Year available 2018
Sub-type Article (original research)
DOI 10.1111/tid.12877
Open Access Status Not yet assessed
Start page e12877
Total pages 8
Place of publication Hoboken, NJ., United States
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2747 Transplantation
2725 Infectious Diseases
Abstract Most studies of post-transplant CMV infection have focused on either solid organ or hematopoietic cell transplant (HCT) recipients. A large prospective cohort study involving both lung and HCT recipients provided an opportunity to compare the epidemiology and outcomes of CMV infections in these two groups.

Patients were followed for 30 months in a 6-center prospective cohort study. Data on demographics, CMV infections, tissue-invasive disease, recurrences, rejection, and immunosuppression were recorded.

The overall incidence of CMV infection was 83/293 (28.3%) in the lung transplant group and 154/444 (34.7%) in the HCT group (p = 0.0706). Tissue-invasive CMV disease occurred in 8/83 (9.6%) of lung and 6/154 (3.9%) of HCT recipients with CMV infection, respectively (p=0.087). Median time to CMV infection was longer in the lung transplant group (236 vs. 40 days, p < 0.0001), likely reflecting the effects of prophylaxis vs. pre-emptive therapy. Total IgG levels of < 350 mg/dl in lung recipients and graft versus host disease (GvHD) in HCT recipients were associated with increased CMV risk. HCT recipients had a higher mean number of CMV episodes (p=0.008), although duration of viremia was not significantly different between the two groups. CMV infection was not associated with reduced overall survival in either group.

Current CMV prevention strategies have resulted in a low incidence of tissue-invasive disease in both lung transplant and HCT, although CMV viremia is still relatively common. Differences between the lung and HCT groups in terms of time to CMV and recurrences of CMV viremia likely reflect differences in underlying host immunobiology and in CMV prevention strategies in the modern era. This article is protected by copyright. All rights reserved.
Keyword Cytomegalovirus
Lung transplant
Multicenter cohort study
Stem cell transplant
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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Created: Wed, 14 Mar 2018, 10:06:14 EST