dc.contributor.author | Blom, Kjersti Benedicte | |
dc.contributor.author | Kro, Grete Anette Birkeland | |
dc.contributor.author | Midtvedt, Karsten | |
dc.contributor.author | Jenssen, Trond | |
dc.contributor.author | Reisæter, Anna Varberg | |
dc.contributor.author | Rollag, Halvor | |
dc.contributor.author | Hartmann, Anders | |
dc.contributor.author | Sagedal, Solbjørg | |
dc.contributor.author | Sjaastad, Ivar | |
dc.contributor.author | Tylden, Garth Daryl | |
dc.contributor.author | Njølstad, Gro | |
dc.contributor.author | Nilsen, Einar | |
dc.contributor.author | Christensen, Andreas | |
dc.contributor.author | Åsberg, Anders | |
dc.contributor.author | Birkeland, Jon Arne | |
dc.date.accessioned | 2024-02-14T15:19:19Z | |
dc.date.available | 2024-02-14T15:19:19Z | |
dc.date.created | 2023-07-21T10:16:31Z | |
dc.date.issued | 2023 | |
dc.identifier.citation | Transplantation. 2023, 107 (8), 1846-1853. | en_US |
dc.identifier.issn | 0041-1337 | |
dc.identifier.uri | https://hdl.handle.net/11250/3117656 | |
dc.description.abstract | Background.
Following kidney transplantation (KT), cytomegalovirus (CMV) infection remains an important challenge. Both prophylactic and preemptive antiviral protocols are used for CMV high-risk kidney recipients (donor seropositive/recipient seronegative; D+/R–). We performed a nationwide comparison of the 2 strategies in de novo D+/R– KT recipients accessing long-term outcomes.
Methods.
A nationwide retrospective study was conducted from 2007 to 2018, with follow-up until February 1, 2022. All adult D+/R– and R+ KT recipients were included. During the first 4 y, D+/R– recipients were managed preemptively, changing to 6 mo of valganciclovir prophylaxis from 2011. To adjust for the 2 time eras, de novo intermediate-risk (R+) recipients, who received preemptive CMV therapy throughout the study period, served as longitudinal controls for possible confounders.
Results.
A total of 2198 KT recipients (D+/R–, n = 428; R+, n = 1770) were included with a median follow-up of 9.4 (range, 3.1–15.1) y. As expected, a greater proportion experienced a CMV infection in the preemptive era compared with the prophylactic era and with a shorter time from KT to CMV infection (P < 0.001). However, there were no differences in long-term outcomes such as patient death (47/146 [32%] versus 57/282 [20%]; P = 0.3), graft loss (64/146 [44%] versus 71/282 [25%]; P = 0.5), or death censored graft loss (26/146 [18%] versus 26/282 [9%]; P = 0.9) in the preemptive versus prophylactic era. Long-term outcomes in R+ recipients showed no signs of sequential era–related bias.
Conclusions.
There were no significant differences in relevant long-term outcomes between preemptive and prophylactic CMV-preventive strategies in D+/R– kidney transplant recipients. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Wolters Kluwer | en_US |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/deed.no | * |
dc.title | Cytomegalovirus High-risk Kidney Transplant Recipients Show No Difference in Long-term Outcomes Following Preemptive Versus Prophylactic Management | en_US |
dc.title.alternative | Cytomegalovirus High-risk Kidney Transplant Recipients Show No Difference in Long-term Outcomes Following Preemptive Versus Prophylactic Management | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.source.pagenumber | 1846-1853 | en_US |
dc.source.volume | 107 | en_US |
dc.source.journal | Transplantation | en_US |
dc.source.issue | 8 | en_US |
dc.identifier.doi | 10.1097/TP.0000000000004615 | |
dc.identifier.cristin | 2162997 | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |