Survey of Post-Prophylaxis Delayed-Onset Cytomegalovirus Management Strategies Among Transplant Providers

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-10-30 DOI:10.1111/ctr.70015

Lemuel R. Non, Chen Sabrina Tan, Dilek Ince, Raymund R. Razonable

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引用次数: 0

Abstract

Background

Preventive strategies for cytomegalovirus (CMV) in the posttransplant period have changed the pattern of CMV infections, now more commonly manifesting as late-onset occurrences known as post-prophylaxis delayed-onset CMV disease (PPDOC). We conducted a survey to investigate provider practices in managing PPDOC.

Methods

A web-based provider survey on the management of PPDOC was developed using Research Electronic Data Capture (REDCap). It was distributed to the online forums of the American Society of Transplantation communities of practice (COP) for Infectious Diseases (IDCOP), Kidney and Pancreas (KPCOP), Liver and Intestinal (LICOP), and Thoracic and Critical Care (TCCOP). The survey was posted twice within a span of a month.

Results

Fifty-six respondents, comprising 50 (89%) transplant physicians and 6 (11%) transplant pharmacists, from 46 distinct transplant centers, completed the survey. Universal antiviral prophylaxis (UAP) was the predominant preventive approach for both high-risk (85%) and moderate-risk (85%) transplant recipients. Out of 56, 51 respondents completed the questions regarding management of PPDOC. Regular surveillance with nucleic acid amplification tests (NAAT) (88%) was the most commonly used approach in high-risk recipients, while symptom monitoring (73%) was the most common strategy in moderate-risk recipients. Immunologic monitoring was used only by a few respondents who found it moderately useful in high-risk recipients.

Conclusion

Management of PPDOC was highly variable among providers and strategies differed based on patient risk profile. These findings could help shape future studies and guidelines to harmonize CMV management.

Abstract Image

查看原文本刊更多论文

器官移植提供者对预防后延迟发病巨细胞病毒管理策略的调查。

背景：移植后巨细胞病毒（CMV）的预防策略改变了 CMV 感染的模式，现在更多的表现为晚期发病，即预防后迟发 CMV 病（PPDOC）。我们开展了一项调查，研究医疗服务提供者在管理 PPDOC 方面的做法：方法：我们使用研究电子数据采集（REDCap）开发了一项关于 PPDOC 管理的网络医疗服务提供者调查。该调查表被发布到美国移植学会传染病实践社区（IDCOP）、肾脏和胰腺实践社区（KPCOP）、肝脏和肠道实践社区（LICOP）以及胸腔和重症监护实践社区（TCCOP）的在线论坛上。调查在一个月内发布了两次：来自 46 个不同移植中心的 56 名受访者完成了调查，其中包括 50 名（89%）移植医生和 6 名（11%）移植药剂师。普遍抗病毒预防（UAP）是高风险（85%）和中度风险（85%）移植受者的主要预防方法。在 56 位受访者中，有 51 位完成了有关 PPDOC 管理的问题。使用核酸扩增检测（NAAT）进行定期监测（88%）是高风险受者最常用的方法，而症状监测（73%）是中度风险受者最常用的策略。只有少数受访者使用免疫学监测，他们认为这种方法对高危受者的作用一般：结论：医疗服务提供者对 PPDOC 的管理存在很大差异，根据患者的风险状况采取的策略也不尽相同。这些研究结果有助于制定未来的研究和指南，以协调 CMV 管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.