Prophylaxis of Cytomegalovirus Infection in Solid Organ Transplantation, Retrospective Evaluation

Abstract

Introduction: Cytomegalovirus infection is one of the opportunistic infections that occur within the first year of solid organ transplantation (SOT). Antiviral prophylaxis like valganciclovir is recommended for organ transplant recipients if the donors are seropositive. The study aims to assess the association between compliance with CMV prevention guidelines and the incidence of CMV infection post kidney and liver transplantation. Methods: A single-center, cross-sectional chart review study was conducted at a tertiary care facility. The study included patients with liver and/or kidney transplantation and received valganciclovir for CMV prevention. The primary endpoint is to determine the incidence of CMV post SOT. The secondary endpoint is to assess the association between compliance with the CMV prevention guidelines and the incidence of CMV infection. Descriptive statistics were used to report the incidence of CMV and logistic regression for risk factor comparisons. The study was approved by the Institutional Review Board. Results: A total of 493 patients had a mean age of 48.6 ± 15.3 years were included. For the primary endpoint, there were a total of 257 patients with CMV occurrence (52.1%). For the secondary endpoint, there was no statistically significant association between CMV incidence and starting CMV prophylaxis agent post-transplantation within 10 days post-transplant (p < 0.75) and duration of CMV prophylactic medications (p < 0.47). In this study, the cases of CMV disease that occurred within 3–6 months following completion of antiviral prophylaxis were in 28% of the patients. Other factors associated with increased risk of CMV infection were evaluated. Conclusion: We found about 28% of CMV infection cases occurred within 3–6 months following completion of antiviral prophylaxis. This was attributed to non-adherence to prophylaxis guidelines. The study has shown that there is a need for improvement in clinical practice. Future studies should address the optimal duration of the CMV prophylaxis.