Use of Letermovir as Secondary Prophylaxis in Cytomegalovirus Resistant Pediatric Heart Transplant Recipients

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-05-28 DOI:10.1111/ctr.70187

John-Anthony Coppola, Debbie-Ann Shirley, Emily Martin, Varvara Probst, Dipankar Gupta

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Abstract

Introduction

Cytomegalovirus (CMV) is a prevalent DNA virus that is a well-recognized cause of significant complications in post-transplant recipients. Emergence of CMV resistance to standard antiviral agents poses a substantial challenge for appropriate management post-transplantation. Currently, there are no pediatric heart transplant data on the use of novel agents such as letermovir for the management of resistant CMV infection.

Methods

We present our experience using letermovir in the management of three pediatric heart transplant recipients with CMV infection who developed resistance to standard therapy. Informed consent was not required.

Results

Letermovir was successfully used for secondary prophylaxis in three patients, all with ganciclovir resistant CMV infection due to UL97 mutations, with no evidence of CMV breakthrough infection and no significant side effects observed.

Conclusion

In our experience, letermovir was well tolerated and effective in the management of resistant CMV in pediatric heart transplant recipients.

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在巨细胞病毒抵抗的儿童心脏移植受者中使用莱特莫韦作为二级预防药物

巨细胞病毒（CMV）是一种流行的DNA病毒，是移植后受者显著并发症的公认原因。巨细胞病毒对标准抗病毒药物的耐药性的出现对移植后的适当管理提出了重大挑战。目前，还没有关于使用利特莫韦等新型药物治疗耐药巨细胞病毒感染的儿童心脏移植数据。方法我们介绍了我们在治疗3例对标准治疗产生耐药性的CMV感染的儿童心脏移植受者中使用letermovir的经验。不需要知情同意。结果3例患者均为UL97突变所致的更昔洛韦耐药巨细胞病毒感染，Letermovir成功用于二级预防，未发现巨细胞病毒突破感染的证据，也未观察到明显副作用。结论根据我们的经验，莱特莫韦在治疗儿童心脏移植受者的耐药巨细胞病毒方面具有良好的耐受性和有效性。

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.