Universal prophylaxis or preemptive strategy for cytomegalovirus disease after liver transplantation: A systematic review and meta-analysis

American Journal of Transplantation

Volumn 15, Issue 2, 2015, Pages 472-481

  Mumtaz, K ^a   Faisal, N ^b   Husain, S ^c   Morillo, A ^b   Renner, E L ^b   Shah, P S ^b  

^a THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER   (United States)

^b UNIVERSITY OF TORONTO   (Canada)

^c UNIVERSITY HEALTH NETWORK   (Canada)

Author keywords

Antibiotic: antiviral ganciclovir valganciclovir; clinical research practice; infection and infectious agents; infectious disease; liver transplantation hepatology; meta analysis; rejection: acute; viral: Cytomegalovirus (CMV)

Indexed keywords

ACICLOVIR; ANTIVIRUS AGENT; GANCICLOVIR; IMMUNOGLOBULIN; VALGANCICLOVIR;

ACUTE GRAFT REJECTION; ANTIVIRAL THERAPY; ARTICLE; COCHRANE LIBRARY; CONFIDENCE INTERVAL; CYTOMEGALOVIRUS; CYTOMEGALOVIRUS INFECTION; DATA COLLECTION METHOD; EMBASE; GRAFT FAILURE; GRAFT RECIPIENT; HIGH RISK POPULATION; HUMAN; INCIDENCE; INFECTION PREVENTION; LIVER TRANSPLANTATION; MEDLINE; META ANALYSIS; NEWCASTLE OTTAWA SCALE; OBSERVATIONAL STUDY; ORGAN DONOR; OUTCOME ASSESSMENT; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RATING SCALE; RISK ASSESSMENT; RISK FACTOR; SEROLOGY; SURGICAL MORTALITY; SYSTEMATIC REVIEW; ADULT; AGED; ANALOGS AND DERIVATIVES; COMPARATIVE STUDY; CYTOMEGALOVIRUS INFECTIONS; FEMALE; GRAFT REJECTION; LIVER DISEASES; MALE; MIDDLE AGED; SURVIVAL RATE; VIROLOGY;

ADULT; AGED; ANTIVIRAL AGENTS; CYTOMEGALOVIRUS INFECTIONS; FEMALE; GANCICLOVIR; GRAFT REJECTION; HUMANS; INCIDENCE; LIVER DISEASES; LIVER TRANSPLANTATION; MALE; MIDDLE AGED; RISK ASSESSMENT; SURVIVAL RATE;

EID: 84921599115     PISSN: 16006135     EISSN: 16006143     Source Type: Journal    
DOI: 10.1111/ajt.13044     Document Type: Article

References (64)

1. Humar A, Michaels M., American Society of Transplantation recommendations for screening, monitoring and reporting of infectious complications in immunosuppression trials in recipients of organ transplantation. Am J Transplant 2006; 6: 262-274.
2. Razonable RR, Humar A., Cytomegalovirus in solid organ transplantation. Am J Transplant 2013; 13: 93-106.
3. Gane E, Saliba F, Valdecasas GJ, et al. Randomized trial of efficacy and safety of oral ganciclovir in the prevention of cytomegalovirus disease in liver-transplant recipients. The Oral Ganciclovir International Transplantation Study Group. Lancet 1997; 350: 1729-1733.
4. Singh N, Wannstedt C, Keyes L, Wagener MM, Cacciarelli TV., Who among cytomegalovirus-seropositive liver transplant recipients is at risk for cytomegalovirus infection ? Liver Transpl 2005; 11: 700-704.
5. Bruminhent J, Razonable RR., Management of cytomegalovirus infection and disease in liver transplant recipients. World J Hepatol 2014; 6: 370-383.
6. Paya C, Humar A, Dominguez E, et al. Efficacy and safety of valganciclovir vs. oral ganciclovir for prevention of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant 2004; 4: 611-620.
7. Levitsky J, Singh N, Wagener MM, Stosor V, Abecassis M, Ison MG., A survey of CMV prevention strategies after liver transplantation. Am J Transplant 2008; 8: 158-161.
8. Kalil AC, Levitsky J, Lyden E, Stoner J, Freifeld AG., Meta-analysis: The efficacy of strategies to prevent organ disease by cytomegalovirus in solid organ transplant recipients. Ann Intern Med 2005; 143: 870-880.
9. Florescu DF, Qiu F, Schmidt CM, Kalil AC., A direct and indirect comparison meta-analysis on the efficacy of cytomegalovirus preventive strategies in solid organ transplant. Clin Infect Dis 2014; 58: 785-803.
10. Owers DS, Webster AC, Strippoli GF, Kable K, Hodson EM., Pre-emptive treatment for cytomegalovirus viraemia to prevent cytomegalovirus disease in solid organ transplant recipients. Cochrane Database Syst Rev 2013; 2: CD005133.
11. Kalil AC, Mindru C, Botha JF, et al. Risk of cytomegalovirus disease in high-risk liver transplant recipients on valganciclovir prophylaxis: A systematic review and meta-analysis. Liver Transpl 2012; 18: 1440-1447.
12. Krom RA, Torres VE, Sterioff S, Wilkowske CJ., Efficacy of ganciclovir in liver and kidney transplant recipients with severe cytomegalovirus infection. Transplantation 1988; 46: 229-234.
13. Pescovitz MD, Rabkin J, Merion RM, et al. Valganciclovir results in improved oral absorption of ganciclovir in liver transplant recipients. Antimicrob Agents Chemother 2000; 44: 2811-2815.
14. Singh N, Yu VL, Mieles L, Wagener MM, Miner RC, Gayowski T., High-dose acyclovir compared with short-course preemptive ganciclovir therapy to prevent cytomegalovirus disease in liver transplant recipients, a randomized trial. Ann Intern Med 1994; 120: 375-381.
15. Badley AD, Seaberg EC, Porayko MK, et al. Prophylaxis of cytomegalovirus infection in liver transplantation: A randomized trial comparing a combination of ganciclovir and acyclovir to acyclovir. NIDDK Liver Transplantation Database. Transplantation 1997; 64: 66-73.
16. Cohen AT, O'Grady JG, Sutherland S, Sallie R, Tan KC, Williams R., Controlled trial of prophylactic versus therapeutic use of ganciclovir after liver transplantation in adults. J Med Virol 1993; 40: 5-9.
17. Lumbreras C, Otero JR, Herrero JA, et al. Ganciclovir prophylaxis decreases frequency and severity of cytomegalovirus disease in seropositive liver transplant recipients treated with OKT3 monoclonal antibodies. Antimicrob Agents Chemother 1993; 37: 2490-2492.
18. Kim WR, Badley AD, Wiesner RH, et al. The economic impact of cytomegalovirus infection after liver transplantation. Transplantation 2000; 69: 357-361.
19. Mañez R, St George K, Linden P, et al. Diagnosis of cytomegalovirus infections by shell vial assay and conventional cell culture during antiviral prophylaxis. J Clin Microbiol 1994; 32: 2655-2659.
20. Martin M, Mañez R, Linden P, et al. A prospective randomized trial comparing sequential ganciclovir-high dose acyclovir to high dose acyclovir for prevention of cytomegalovirus disease in adult liver transplant recipients. Transplantation 1994; 58: 779-785.
21. Rabkin JM, Rosen HR, Corless CL, Orloff SL, Olyaei AJ., Prophylactic antiviral therapy in CMV high-risk liver transplant recipients. Transplant Proc 2001; 33: 1811-1812.
22. Winston DJ, Wirin D, Shaked A, Busuttil RW., Randomized comparison of ganciclovir and high-dose acyclovir for long-term cytomegalovirus prophylaxis in liver-transplant recipients. Lancet 1995; 346: 69-74.
23. Gane E, Saliba F, Valdecasas GJ, et al. Randomized trial of efficacy and safety of oral ganciclovir in the prevention of cytomegalovirus disease in liver-transplant recipients. Lancet 1997; 350: 1729-1733.
24. Saliba F, Arulnaden JL, Gugenheim J, et al. CMV hyperimmune globulin prophylaxis after liver transplantation: A prospective randomized controlled study. Transplant Proc 1989; 21: 2260-2262.
25. Freise CE, Hebert M, Osorio RW, et al. Maintenance immunosuppression with prednisone and RS-61443 alone following liver transplantation. Transplant Proc 1993; 25: 1758-1759.
26. Nakazato PZ, Burns W, Moore P, Garcia-Kennedy R, Cox K, Esquivel C., Viral prophylaxis in hepatic transplantation: Preliminary report of a randomized trial of acyclovir and gancyclovir. Transplant Proc 1993; 25: 1935-1937.
27. Pan SH, Rosenthal P, Howard TK, Podesta LG, Sher L, Makowka L., Evaluation of three cytomegalovirus infection prophylactic regimens in liver transplant recipients. Transplant Proc 1992; 24: 1466-1467.
28. Arthurs SK, Eid AJ, Pedersen RA, et al. Delayed-onset primary cytomegalovirus disease after liver transplantation. Liver Transpl 2007; 13: 1703-1709.
29. Donnelly C, Kennedy F, Keane C, Schaffer K, McCormick PA., Late-onset CMV disease following CMV prophylaxis. Ir J Med Sci 2009; 178: 333-336.
30. Kim JM, Kim SJ, Joh JW, et al. Early and delayed onset cytomegalovirus infection of liver transplant recipients in endemic areas. Transplantation Proc 2010; 42: 884-889.
31. Wells GA, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. 2011. Available at: http://www.ohri.ca/programs/clinical-epidemiology/oxford.asp. Accessed November 26, 2014.
32. Wood L, Egger M, Gluud LL, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: Meta-epidemiological study. BMJ 2008; 336: 601-605.
33. Wallace BC, Schmidt CH, Lau J, Trikalinos TA., Meta-analyst: Software for meta-analysis of binary, continuous and diagnostic data. BMC Med Res Methodol 2009; 9: 80.
34. Higgins JP, Thompson SG, Deeks JJ, Altman DG., Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560.
35. Brady RL, Green K, Frei C, Maxwell P., Oral ganciclovir versus valganciclovir for cytomegalovirus prophylaxis in high-risk liver transplant recipients. Transpl Infect Dis 2009; 11: 106-111.
36. Fayek SA, Mantipisitkul W, Rasetto F, Munivenkatappa R, Barth RN, Philosophe B., Valganciclovir is an effective prophylaxis for cytomegalovirus disease in liver transplant recipients. HPB 2010; 12: 657-663.
37. Park JM, Lake KD, Arenas JD, Fontana RJ., Efficacy and safety of low-dose valganciclovir in the prevention of cytomegalovirus disease in adult liver transplant recipients. Liver Transplant 2006; 12: 112-116.
38. Shiley KT, Gasink LB, Barton TD, Pfeiffenberger P, Olthoff KM, Blumberg EA., Increased incidence of cytomegalovirus infection in high-risk liver transplant recipients receiving valganciclovir prophylaxis versus ganciclovir prophylaxis. Liver Transplant 2009; 15: 963-967.
39. Leong RW, Smith DW, Garas G, et al. Aciclovir or ganciclovir universal prophylaxis of cytomegalovirus infection in liver transplantation: An economic analysis. Intern Med J 2004; 34: 410-415.
40. Winston DJ, Busuttil RW., Randomized controlled trial of sequential intravenous and oral ganciclovir versus prolonged intravenous ganciclovir for long-term prophylaxis of cytomegalovirus disease in high-risk cytomegalovirus-seronegative liver transplant recipients with cytomegalovirus-seropositive donors. Transplantation 2004; 77: 305-308.
41. Winston DJ, Busuttil RW., Randomized controlled trial of oral ganciclovir versus oral acyclovir after induction with intravenous ganciclovir for long-term prophylaxis of cytomegalovirus disease in cytomegalovirus-seropositive liver transplant recipients. Transplantation 2003; 75: 229-233.
42. Jain A, Orloff M, Kashyap R, et al. Does valganciclovir hydrochloride provide effective prophylaxis against cytomegalovirus infection in liver transplant recipients ? Transplant Proc 2005; 37: 3182-3186.
43. Lianghui G, Shusen Z, Tingbo L, Yan S, Weilling W, Anwei L., Deferred versus prophylactic therapy with ganciclovir for cytomegalovirus in allograft liver transplantation. Transplant Proc 2004; 36: 1502-1505.
44. Scott GM, Naing Z, Pavlovic J, et al. Viral factors influencing the outcome of human cytomegalovirus infection in liver transplant recipients. J Clin Virol 2011; 51: 229-233.
45. Limaye AP, Bakthavatsalam R, Kim HW, et al. Late-onset cytomegalovirus disease in liver transplant recipients despite antiviral prophylaxis. Transplantation 2004; 78: 1390-1396.
46. Dupuis R, Harris M, Gillis K, et al. Experience with low-dose valganciclovir prophylaxis in adult liver transplant recipients. Transplant Proc 2007; 39: 3266-3270.
47. Bodro M, Sabé N, Lladõ L, et al. Prophylaxis versus preemptive therapy for cytomegalovirus disease in high-risk liver transplant recipients. Liver Transpl 2012; 18: 1093-1099.
48. Montejo M, Montejo E, Gastaca M, et al. Prophylactic therapy with valgancyclovir in high-risk (cytomegalovirus D+/R-) liver transplant recipients: A single-center experience. Transplantation Proc 2009; 41: 2189-2191.
49. Smallwood GA, de Vera ME, Davis L, Martinez E, Stieber AC, Heffron TG., Preemptive ganciclovir for CMV viremia in liver transplantation. Transplant Proc 2001; 33: 1814-1815.
50. Singh N, Wannstedt C, Keyes L, Gayowski T, Wagener MM, Cacciarelli TV., Efficacy of valganciclovir administered as preemptive therapy for cytomegalovirus disease in liver transplant recipients: Impact on viral load and late-onset cytomegalovirus disease. Transplantation 2005; 79: 85-90.
51. Razonable RR, van Cruijsen H, Brown RA, et al. Dynamics of cytomegalovirus replication during preemptive therapy with oral ganciclovir. J Infect Dis 2003; 187: 1801-1808.
52. Togashi J, Sugawara Y, Hashimoto M, et al. Oral valganciclovir versus intravenous ganciclovir as preemptive treatment for cytomegalovirus infection after living donor liver transplantation: A randomized trial. Biosci Trends 2011; 5: 217-222.
53. Rayes N, Seehofer D, Schmidt CA, et al. Prospective randomized trial to assess the value of preemptive oral therapy for CMV infection following liver transplantation. Transplantation 2001; 72: 881-885.
54. Singh N, Paterson DL, Gayowski T, Wagener MM, Marino IR., Cytomegalovirus antigenemia directed pre-emptive prophylaxis with oral versus I.V. ganciclovir for the prevention of cytomegalovirus disease in liver transplant recipients: A randomized, controlled trial. Transplantation 2000; 70: 717-722.
55. Torre-Cisneros J, Madueno JA, Herrero C, et al. Pre-emptive oral ganciclovir can reduce the risk of cytomegalovirus disease in liver transplant recipients. Clin Microbiol Infect 2002; 8: 773-780.
56. Dahiya D, Lee CF, Chan KM, et al. A short-term preemptive treatment for cytomegalovirus infection in seropositive patients after liver transplantation. J Hepatobiliary Pancreat Sci 2011; 18: 32-38.
57. Kim JM, Kim SJ, Joh JW, et al. Preemptive therapy in adult liver transplant recipients in CMV-endemic area. Transplant Proc 2010; 42: 825-829.
58. Singh N, Wannstedt C, Keyes L, et al. Valganciclovir as preemptive therapy for cytomegalovirus in cytomegalovirus-seronegative liver transplant recipients of cytomegalovirus-seropositive donor allografts. Liver Transplant 2008; 14: 240-244.
59. Akamatsu N, Sugawara Y, Kaneko J, Kishi Y, Makuuchi M., Risk factors of cytomegalovirus infection after living donor liver transplantation. Hepatogastroenterology 2005; 52: 197-199.
60. Paya CV, Wilson JA, Espy MJ, et al. Preemptive use of oral ganciclovir to prevent cytomegalovirus infection in liver transplant patients: A randomized, placebo-controlled trial. J Infect Dis 2002; 185: 854-860.
61. Sun HY, Cacciarelli TV, Wagener MM, Singh N., Preemptive therapy for cytomegalovirus based on real-time measurement of viral load in liver transplant recipients. Transpl Immunol 2010; 23: 166-169.
62. Hodson EM, Jones CA, Webster AC, et al. Antiviral medications to prevent cytomegalovirus disease and early death in recipients of solid organ transplants: a systematic review of randomised controlled trials. Lancet 2005; 365: 2105-2115.
63. Small LN, Lau J, Snydman DR,. Preventing post-organ transplantation cytomegalovirus disease with ganciclovir: A meta-analysis comparing prophylactic and preemptive therapies. Clin Infect Dis 2006; 43: 869-880.
64. Jung C, Engelmann E, Borner K, Offermann G., Preemptive oral ganciclovir therapy versus prophylaxis to prevent symptomatic cytomegalovirus infection after kidney transplantation. Transplant Proc 2001; 33: 3621-3623.