Abstract 17001: Is There Cytomegalovirus Disease After Prophylaxis?

Abstract

Purpose: Cytomegalovirus (CMV) disease (specific organ involvement) is a significant cause of morbidity and mortality in orthotopic heart transplantation (OHT). CMV disease is reported to increase the development of cardiac allograft vasculopathy (CAV). The duration of CMV prophylaxis in recipients is dependent on their CMV serostatus in relation to the donors. However, the effective duration of CMV prophylaxis post-transplant remains unclear. Methods: Between 2007 and 2012, 267 OHT patients were divided into four groups based on the CMV serostatus of the donors (D) and recipients (R): D+/R-, D+/R+, D-/R+, D-/R-. CMV prophylaxis was given for up to one year in D+/R- patients, up to six months in D+/R+ and D-/R+ patients, and three months in D-/R-. Endpoints included two-year overall survival and freedom from development of CMV disease, CAV, and NF-MACE (defined as myocardial infarction¼..) after the end of CMV prophylaxis in the four study groups, respectively. Results: After the end of respective CMV prophylaxis in the four study groups, there was no significant difference in two-year overall survival and freedom from development of CMV disease, CAV, and NF-MACE among the four groups. Of the D+/R- group, one patient developed CMV gastritis, one patient CMV pneumonia, and one patient CMV colitis. Two patients developed CMV colitis in the D+/R+ group. Conclusions: The current recommendations for the duration of CMV prophylaxis appear to be satisfactory in preventing CMV disease and complications after the end of prophylaxis.