Late cytomegalovirus transmission and impact of T-depletion in clinical islet transplantation.

TitleLate cytomegalovirus transmission and impact of T-depletion in clinical islet transplantation.
Publication TypeJournal Article
Year of Publication2011
AuthorsGala-Lopez BL, Senior PA, Koh A, Kashkoush SM, Kawahara T, Kin T, Humar A, Shapiro AM
JournalAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons//Am J Transplant
Pagination2708 - 14
Date Published2011
ISBN Number1600-6143
Other Numbers100968638
Keywords*Cytomegalovirus Infections/tm [Transmission], *Cytomegalovirus Infections/vi [Virology], *Cytomegalovirus/py [Pathogenicity], *Islets of Langerhans Transplantation/ae [Adverse Effects], *Lymphocyte Depletion, *Postoperative Complications, *T-Lymphocytes/im [Immunology], Antiviral Agents/tu [Therapeutic Use], Canada/ep [Epidemiology], Cytomegalovirus Infections/dt [Drug Therapy], Diabetes Mellitus, Type 1/su [Surgery], Female, Ganciclovir/aa [Analogs & Derivatives], Ganciclovir/tu [Therapeutic Use], Graft Survival/im [Immunology], Humans, Incidence, Male, Prognosis, Risk Factors, Survival Rate, Transplantation Immunology, Treatment Outcome, Viral Load, Viremia/dt [Drug Therapy], Viremia/ep [Epidemiology], Viremia/vi [Virology]

The epidemiology of cytomegalovirus infection (CMV) in islet transplantation (IT) is not well defined. This study defines incidence, transmission and clinical sequelae of CMV reactivation or disease in 121 patients receiving 266 islet infusions at a single institution. The donor (D)/recipient (R) serostatus was D+/R- 31.2%, D+/R+ 26.3%, D-/R+ 13.2% and D-/R- 29.3%. CMV prophylaxis with oral ganciclovir/valganciclovir was given in 68%. CMV infection occurred in 14/121 patients (11.6%); six had asymptomatic seroconversion and eight others had positive viremia (six asymptomatic and two with CMV febrile symptoms). Median peak viral loads were 1755 copies/mL (range 625-9 100 000). Risk factors for viremia included lymphocyte depletion (thymoglobulin or alemtuzumab, p

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