Prevention and Management of CMV Infections after Liver Transplantation: Current Practice in German Transplant Centers
Standard
Prevention and Management of CMV Infections after Liver Transplantation: Current Practice in German Transplant Centers. / Engelmann, Cornelius; Sterneck, Martina; Weiss, Karl Heinz; Templin, Silke; Zopf, Steffen; Denk, Gerald; Eurich, Dennis; Pratschke, Johann; Weiss, Johannes; Braun, Felix; Welker, Martin-Walter; Zimmermann, Tim; Knipper, Petra; Nierhoff, Dirk; Lorf, Thomas; Jäckel, Elmar; Hau, Hans-Michael; Tsui, Tung Yu; Perrakis, Aristoteles; Schlitt, Hans-Jürgen; Herzer, Kerstin; Tacke, Frank.
in: J CLIN MED, Jahrgang 9, Nr. 8, 2352, 23.07.2020.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Prevention and Management of CMV Infections after Liver Transplantation: Current Practice in German Transplant Centers
AU - Engelmann, Cornelius
AU - Sterneck, Martina
AU - Weiss, Karl Heinz
AU - Templin, Silke
AU - Zopf, Steffen
AU - Denk, Gerald
AU - Eurich, Dennis
AU - Pratschke, Johann
AU - Weiss, Johannes
AU - Braun, Felix
AU - Welker, Martin-Walter
AU - Zimmermann, Tim
AU - Knipper, Petra
AU - Nierhoff, Dirk
AU - Lorf, Thomas
AU - Jäckel, Elmar
AU - Hau, Hans-Michael
AU - Tsui, Tung Yu
AU - Perrakis, Aristoteles
AU - Schlitt, Hans-Jürgen
AU - Herzer, Kerstin
AU - Tacke, Frank
PY - 2020/7/23
Y1 - 2020/7/23
N2 - Human cytomegalovirus (CMV) remains a major cause of mortality and morbidity in human liver transplant recipients. Anti-CMV therapeutics can be used to prevent or treat CMV in liver transplant recipients, but their toxicity needs to be balanced against the benefits. The choice of prevention strategy (prophylaxis or preemptive treatment) depends on the donor/recipient sero-status but may vary between institutions. We conducted a series of consultations and roundtable discussions with German liver transplant center representatives. Based on 20 out of 22 centers, we herein summarize the current approaches to CMV prevention and treatment in the context of liver transplantation in Germany. In 90% of centers, transient prophylaxis with ganciclovir or valganciclovir was standard of care in high-risk (donor CMV positive, recipient CMV naive) settings, while preemptive therapy (based on CMV viremia detected during (bi) weekly PCR testing for circulating CMV-DNA) was preferred in moderate- and low-risk settings. Duration of prophylaxis or intense surveillance was 3-6 months. In the case of CMV infection, immunosuppression was adapted. In most centers, antiviral treatment was initiated based on PCR results (median threshold value of 1000 copies/mL) with or without symptoms. Therefore, German transplant centers report similar approaches to the prevention and management of CMV infection in liver transplantation.
AB - Human cytomegalovirus (CMV) remains a major cause of mortality and morbidity in human liver transplant recipients. Anti-CMV therapeutics can be used to prevent or treat CMV in liver transplant recipients, but their toxicity needs to be balanced against the benefits. The choice of prevention strategy (prophylaxis or preemptive treatment) depends on the donor/recipient sero-status but may vary between institutions. We conducted a series of consultations and roundtable discussions with German liver transplant center representatives. Based on 20 out of 22 centers, we herein summarize the current approaches to CMV prevention and treatment in the context of liver transplantation in Germany. In 90% of centers, transient prophylaxis with ganciclovir or valganciclovir was standard of care in high-risk (donor CMV positive, recipient CMV naive) settings, while preemptive therapy (based on CMV viremia detected during (bi) weekly PCR testing for circulating CMV-DNA) was preferred in moderate- and low-risk settings. Duration of prophylaxis or intense surveillance was 3-6 months. In the case of CMV infection, immunosuppression was adapted. In most centers, antiviral treatment was initiated based on PCR results (median threshold value of 1000 copies/mL) with or without symptoms. Therefore, German transplant centers report similar approaches to the prevention and management of CMV infection in liver transplantation.
U2 - 10.3390/jcm9082352
DO - 10.3390/jcm9082352
M3 - SCORING: Journal article
C2 - 32717978
VL - 9
JO - J CLIN MED
JF - J CLIN MED
SN - 2077-0383
IS - 8
M1 - 2352
ER -