Cytomegalovirus Hyper Immunoglobulin for CMV Prophylaxis in Thoracic Transplantation

Transplantation
Federico ReaFiorella Calabrese

Abstract

Cytomegalovirus (CMV) infection negatively influences both short- and long-term outcomes after cardiothoracic transplantation. In heart transplantation, registry analyses have shown that CMV immunoglobulin (CMVIG) with or without virostatic prophylaxis is associated with a significant reduction in mortality and graft loss versus no prophylaxis, particularly in high-risk donor (D)+/recipient (R)- transplants. Randomized comparative trials are lacking but retrospective data suggest that addition of CMVIG to antiviral prophylaxis may reduce rates of CMV-related events after heart transplantation, including the incidence of acute rejection or chronic allograft vasculopathy. However, available data consistently indicate that when CMVIG is used, it should be administered with concomitant antiviral therapy, and that evidence concerning preemptive management with CMVIG is limited, but promising. In lung transplantation, CMVIG should again only be used with concomitant antiviral therapy. Retrospective studies have shown convincing evidence that addition of CMVIG to antiviral prophylaxis lowers CMV endpoints and mortality. The current balance of evidence suggests that CMVIG prophylaxis reduces the risk of bronchiolitis obliterans syndrom...Continue Reading

References

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Citations

Jun 10, 2017·Viral Immunology·Nobuyasu AibaKimiyasu Shiraki
Mar 27, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Johannes GoeklerArezu Z Aliabadi-Zuckermann
Jun 13, 2018·Current Opinion in Infectious Diseases·José G MontoyaRoy Lee
Jun 30, 2019·Clinical Transplantation·Karthik SanthanakrishnanRajamiyer Venkateswaran
Mar 30, 2019·Medical Microbiology and Immunology·Astrid KrmpotićStipan Jonjić
Nov 11, 2020·Lung·Polina TrachukAdam Keene
Feb 12, 2021·Multidisciplinary Respiratory Medicine·Jessica HuntRajat Walia

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