Cytomegalovirus Infection under a Hybrid Strategy in Pediatric Liver Transplantation: A Single-Center Experience.
10.5223/pghn.2017.20.3.178
- Author:
Ryung KIM
1
;
Dai JOUNG
;
Sunghee LEE
;
Insook JEONG
;
Seak Hee OH
;
Jung Man NAMGOONG
;
Dae Yeon KIM
;
Kyung Mo KIM
Author Information
1. Department of Pediatric, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea. seakhee.oh@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Cytomegalovirus;
Liver transplantation, Child;
Hybrid strategy;
Quantitative nucleic acid amplification test
- MeSH:
Child;
Consensus;
Cytomegalovirus Infections*;
Cytomegalovirus*;
Ganciclovir;
Humans;
Incidence;
Liver Transplantation*;
Liver*;
Living Donors;
Mortality;
Nucleic Acid Amplification Techniques
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2017;20(3):178-185
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the outcomes of a hybrid prophylactic strategy to prevent cytomegalovirus (CMV) disease in pediatric liver transplantation (LT) patients. METHODS: CMV DNAemia was regularly monitored by quantitative nucleic acid amplification test (QNAT) and was quantified in all children. CMV infection and disease were defined according to the International Consensus Guidelines. The hybrid strategy against CMV infection consisted of universal 3-week prophylaxis and preemptive treatment of intravenous ganciclovir regardless of the recipient's serostatus. RESULTS: A total of 143 children who underwent living donor LT were managed using the hybrid strategy. The overall incidence of CMV infection by QNAT was 48.3% (n=69/143). The highest CMV DNAemia positivity was observed in 49.2% (n=60/122) of children in the D+/R+ group, followed by 46.7% (n=7/15) in the D+/R− group. CMV disease was noted in 26.1% (n=18/69) patients. Forty-three (62.3%) children had undergone preemptive therapy consisting of intravenous ganciclovir. No symptomatic patients developed tissue-invasive disease, resulting in no CMV-associated mortality. CONCLUSION: The incidence of CMV infection was high in pediatric LT patients despite the hybrid strategy. However, tissue-invasive disease in pediatric LT did not occur.
