Faculty Collaboration Database

The clinical impact of ganciclovir prophylaxis on the occurrence of bacteremia in orthotopic liver transplant recipients. Clin Infect Dis 2004 Nov 01;39(9):1293-9

Date

10/21/2004

Pubmed ID

15494905

DOI

10.1086/425002

Scopus ID

2-s2.0-7644237790 (requires institutional sign-in at Scopus site)   69 Citations

Abstract

BACKGROUND: Cytomegalovirus (CMV) infection or receipt of a CMV-seropositive donor liver has been shown to be an independent predictor of bacteremia in orthotopic liver transplant (OLT) recipients. However, prevention of CMV infection through use of intense CMV prophylaxis has not been examined to assess the impact on bacteremia in liver transplant recipients.

METHODS: We analyzed the impact of CMV prophylaxis on rates of bacteremia by examining 192 consecutive OLT recipients during a 2-year follow-up period.

RESULTS: There were 29 episodes of bacteremia. Univariate analysis of risk factors for bacteremia showed that invasive fungal disease, initial anti-lymphocyte immunosuppression, treatment for rejection, and use of solumedrol were significantly associated with increased risk. Receipt of >or=14 days of ganciclovir prophylaxis (hazard ratio [HR], 0.40; 95% CI [confidence interval], 0.18-0.87; P=.02), end-to-end biliary anastomosis, and receipt of <10 units of red blood cells (RBCs) were significantly associated with a decreased risk. Three-variable analysis controlling for end-to-end anastomosis and use of <10 units of RBCs, showed that use of >or=14 days of ganciclovir was still associated with a reduced risk of bacteremia (HR, 0.44; 95% CI, 0.20-0.98; P=.0437).

CONCLUSIONS: Among factors associated with bacteremia, use of prophylactic ganciclovir is independently associated with a significant reduction of bacteremia in OLT recipients.

Author List

Munoz-Price LS, Slifkin M, Ruthazer R, Poutsiaka DD, Hadley S, Freeman R, Rohrer R, Angelis M, Cooper J, Fairchild R, Barefoot L, Bloom J, Fitzmaurice S, Snydman DR

MESH terms used to index this publication - Major topics in bold

Adult
Antibodies, Viral
Antiviral Agents
Bacteremia
Cytomegalovirus Infections
Female
Ganciclovir
Humans
Liver Transplantation
Male
Middle Aged
Multivariate Analysis
Risk Factors
Time Factors