(852) - Outcomes Associated with Ganciclovir-Resistant Cytomegalovirus in Lung Transplant Recipients

Abstract

Cytomegalovirus (CMV) is a major cause of morbidity and mortality in lung transplant recipients (LTR). Studies comparing outcomes between wild type CMV and resistant CMV (rCMV) are lacking. The purpose of this study is to compare outcomes between wild-type CMV and rCMV in LTR. This is an IRB-approved, single-center retrospective study of LTR who were transplanted between 1/10 and 12/14 and developed CMV viremia. Patients who received multi-organ transplants and re-transplants were excluded. Patients were categorized as having rCMV if they had at least one documented CMV panel indicating resistance to ganciclovir, foscarnet, and/or cidofovir. The primary outcome was rate of acute cellular rejection (ACR) after CMV infection. Secondary outcomes included time to ACR, time to resolution of CMV, CMV recurrence, and mortality. 299 patients received a lung transplant during the study period. 98 (33%) developed CMV and 90 were included for analysis. 74 patients (25%) had CMV and 16 (5%) developed rCMV. Baseline characteristics are described in Table 1 and outcomes in Table 2. All LTR in the rCMV group were D+/R-. There were no statistical differences in the rate or time to onset of ACR from infection, duration of viremia, or graft or patient survival. There was a statistically higher rate of recurrence in the rCMV group (80% vs. 28%, p< 0.05). This study did not identify a difference in rate or onset of ACR between in LTR wild-type and resistant CMV, however there was a higher rate of recurrence in the resistant CMV group. Additional study is warranted to characterize the risk factors for and impact of rCMV on LTR.