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Incidence and risk factors associated with the development of cytomegalovirus disease after intestinal transplantation

Mañez, R and Kusne, S and Green, M and Ajbu-Elmagd, K and Irish, W and Reyes, J and Furukawa, H and Tzλkis, A and Fung, JJ and Todo, S and Starzl, TE (1995) Incidence and risk factors associated with the development of cytomegalovirus disease after intestinal transplantation. Transplantation, 59 (7). 1010 - 1014. ISSN 0041-1337

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Abstract

From May 1990 to March 1993, 38 patients (21 adults and 17 children) received 40 allografts that included the small bowel (14 isolated small bowel, 21 small bowel and liver, and 5 multivisceral transplantations). Fifteen patients (39%) had 26 episodes of CMV disease: 7 with one episode, 6 with two, and 1 each with three and four. CMV enteritis accounted for 21 (81%) of the episodes, hepatitis and pneumonitis for 2 each, and a viral syndrome for 1. Cox’s proportional hazards univariate and multivariate analyses showed that significant first-episode risk factors were: CMV seropositive donors for negative recipients (relative risk [RR], 3.86; P=0.02), the average daily plasma trough level of tacrolimus (RR, 2.15; P=0.04), and total amount of steroid boluses (RR, 2.90; P=0.02). CMV disease recurrence factors were: CMV seronegative recipients (RR, 8.60; P=0.02) and total amount of steroid bolus pulses (RR, 12.39; P=0.004). Because long courses of ganciclovir prophylaxis could not prevent the development of CMV disease, avoidance of CMV seropositive grafts in seronegative recipients and new strategies to prevent heavy immunosuppression without the penalty of rejection will be necessary to ameliorate this problem in intestinal transplant recipients. © 1995 by Williams and Wilkins.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mañez, R
Kusne, S
Green, Mgreenm@pitt.eduGREENM
Ajbu-Elmagd, K
Irish, W
Reyes, J
Furukawa, H
Tzλkis, A
Fung, JJ
Todo, S
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 15 April 1995
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 59
Number: 7
Page Range: 1010 - 1014
DOI or Unique Handle: 10.1097/00007890-199504150-00016
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062126218, Starzl CV No. 1771
Date Deposited: 08 Apr 2010 17:30
Last Modified: 19 Jan 2019 13:55
URI: http://d-scholarship.pitt.edu/id/eprint/5157

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