| Long-term efficacy and safety of 12 months of valganciclovir prophylaxis compared with 3 months after lung transplantation: A single-center, long-term follow-up analysis from a randomized, controlled cytomegalovirus prevention trial. | |
| | |
MedLine Citation:
|
PMID: 21489817 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: The optimal approach to cytomegalovirus (CMV) prevention after lung transplantation is controversial. We recently completed a prospective, randomized, placebo-controlled study of CMV prevention in lung transplantation that demonstrated the short-term efficacy and safety of extending valganciclovir prophylaxis to 12 months vs 3 months of therapy. In the current analysis, we monitored a single-center subset of patients enrolled in the CMV prevention trial to determine if extended prophylaxis conferred a sustained long-term benefit and to assess its hematologic safety. METHODS: The sub-analysis included 38 randomized patients from Duke University Medical Center. All patients underwent consistent serial serum CMV monitoring and surveillance bronchoscopies. CMV was defined by viremia (≥ 500 CMV DNA copies/ml) or pneumonitis. The safety assessment included a review of all complete blood counts obtained from transplant onward. RESULTS: During a mean follow-up of 3.9 years in each group, extended-course compared with short-course prophylaxis provided a sustained protective benefit with a lifetime CMV incidence of 12% vs 55%, respectively (hazard ratio, 0.13; 95% confidence interval, 0.03-0.61; p = 0.009), an effect that persisted after adjustment for clinical risk factors. Patients in each group underwent a comparable number of peripheral blood draws and bronchoscopies. Post-transplant white blood cell, neutrophil, and platelet counts were similar between each treatment group during the course of follow-up. CONCLUSION: Extending valganciclovir prophylaxis to 12 months provides a durable long-term CMV protective benefit compared with short-course therapy, without increasing adverse hematologic effects. |
| | |
Authors:
|
C Ashley Finlen Copeland; W Austin Davis; Laurie D Snyder; Missy Banks; Robin Avery; R Duane Davis; Scott M Palmer |
Related Documents
:
|
15576217 - Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: a study o... 15234217 - Postoperative stiffness and adhesion formation around repaired and immobilized achilles... 3741597 - The hopping reaction in the rabbit after early and late removal of the motor cortex. 21339057 - Findings of multidetector row computed tomography of hccs treated by hifu ablation. 18562357 - Purulent flexor tenosynovitis: factors influencing the functional outcome. 20151247 - Results and prognostic factors of valgus osteotomy in middle-aged patients with advance... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-4-12 |
Journal Detail:
|
Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: - ISSN: 1557-3117 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
|
Created Date: 2011-4-14 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Medicine, Duke University Medical Center, Durham, North Carolina. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Biventricular cannulation is superior regarding hemodynamics and organ recovery in patients on biven...
Next Document: Impact of extracorporeal life support on outcome in patients with idiopathic pulmonary arterial hype...