The Clinical Impact of Ganciclovir Prophylaxis on the Occurrence of Bacteremia in Orthotopic Liver Transplant Recipients
Open Access
- 1 November 2004
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 39 (9), 1293-1299
- https://doi.org/10.1086/425002
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 ⩾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 P = .0437). Conclusions. Among factors associated with bacteremia, use of prophylactic ganciclovir is independently associated with a significant reduction of bacteremia in OLT recipients.Keywords
This publication has 17 references indexed in Scilit:
- Infection in solid organ transplantationTransplant Infectious Disease, 1999
- SIGNIFICANCE OF CYTOMEGALOVIRUS FOR LONG-TERM SURVIVAL AFTER ORTHOTOPIC LIVER TRANSPLANTATIONTransplantation, 1998
- The Independent Role of Cytomegalovirus as a Risk Factor for Invasive Fungal Disease in Orthotopic Liver Transplant RecipientsAmerican Journal Of Medicine, 1997
- CYTOMEGALOVIRUS DISEASE IS ASSOCIATED WITH INCREASED COST AND HOSPITAL LENGTH OF STAY AMONG ORTHOTOPIC LIVER TRANSPLANT RECIPIENTS1Transplantation, 1997
- Effect of Cytomegalovirus Infection Status on First-Year Mortality Rates among Orthotopic Liver Transplant RecipientsAnnals of Internal Medicine, 1997
- Exposure to Cytomegalovirus from the Donated Organ Is a Risk Factor for Bacteremia in Orthotopic Liver Transplant RecipientsClinical Infectious Diseases, 1996
- Primary Cytomegalovirus Infection in Liver Transplant Recipients: Comparison of Infections Transmitted Via Donor Organs and Via TransfusionsClinical Infectious Diseases, 1996
- RELEVANCE AND RISK FACTORS OF ENTEROCOCCAL BACTEREMIA FOLLOWING LIVER TRANSPLANTATION1Transplantation, 1996
- Risk factors for cytomegalovirus and severe bacterial infections following liver transplantation: a prospective multivariate time-dependent analysisJournal of Hepatology, 1993
- Complications of liver biopsy in liver transplant patients: Increased sepsis associated with choledochojejunostomyHepatology, 1991