Shaúl Ariel Navarro-Lara, Juan José Calva-Mercado, Tomas Rafael Mercado-Torres, Mariana Vélez-Pintado, Bernardo Alfonso Martínez-Guerra, Carla Marina Román-Montes, Sandra Rajme-López, Ever Arturo Corral-Herrera, Héctor Orlando Rivera-Villegas, Nayelli Cointa Flores-García, Luis Eduardo Morales-Buenrostro, María Fernanda González-Lara, Karla María Tamez-Torres
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引用次数: 0
Abstract
Background: Cytomegalovirus (CMV) remains a major cause of morbidity in solid organ transplant (SOT) recipients. While universal prophylaxis and preemptive therapy (PET) are standard strategies, comparative data in Latin American populations-characterized by high CMV seroprevalence-are limited.
Methods: We conducted a retrospective cohort study of 731 adult recipients (2016-2024). Patients were stratified into intermediate (R+) or high-risk (D+/R- or thymoglobulin induction) groups. The primary outcome was proven CMV disease at 12 months. Bias was addressed using Inverse Probability Weighting (IPW).
Results: Of 731 transplants, 311 were high-risk and 420 intermediate-risk. No significant difference was observed in CMV disease incidence between PET (1.9%) and prophylaxis (2.4%) (p = 0.943). IPW confirmed no association between the strategy and CMV infection (OR: 1.21; 95% CI: 0.25-5.57; p = 0.810). Notably, the absence of lymphopenia at 1 month posttransplantation was found to be protective against CMV disease (p < 0.001).
Conclusion: Both strategies were associated with a low incidence of CMV disease. A DNAemia threshold of 4000 IU/mL for PET proved safe across all risk strata. Early absolute lymphocyte count > 1000 cells/µL is a strong predictor of protection against CMV disease.
期刊介绍：
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.
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