1669. Cytomegalovirus (CMV) Disease in Seropositive Heart Transplant Recipients in the Setting of Preemptive Strategy A single center study
Session: Poster Abstract Session: Pre-emptive Therapy in Transplantation and Immunocompromised Hosts
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: Prevention of cytomegalovirus (CMV) infection is one of the most important issues in managing recipients of heart transplantation (HT). While many centers have used prophylactic strategy during early postoperative period after HT, data supporting this practice is scarce and little is known about the natural course of CMV infection in the preemptive strategy. The purpose of this study was to evaluate the incidence, time to occurrence and impact of CMV diseases in CMV-seropositive HT recipients in the context of preemptive strategy.  .

Methods: We performed a retrospective cohort study on 100 consecutive HT recipients at Samsung Medical Center from 1996 to 2012.

Results: Median age at transplantation was 50 years (range 18-77 years). 72 patients (72%) were male and all recipients were CMV seropositive at the time of operation. Among the 100 HT recipients eligible for the analysis during the study period, significant CMV infection (CMV antigenemia ≥ 5/200,000 WBCs or symptomatic CMV disease) occurred in 65 (65.0%) and 35 didn’t have any CMV infection. Overall, CMV disease occurred in 18 (18.0%) out of 100 HT recipients. The median duration from transplantation to occurrence of CMV disease was 52 days (range 21-548 days). Gastrointestinal CMV diseases were the most frequent (11 out of 18, 61.1%), followed by pneumonitis in 4 (22.2%), myocarditis in 2 (11.1%), and retinitis in 1 (5.6%). Overall 26 patients died during the study period (5 out of 18 [27.8%] patients with CMV diseases vs. 21 out of 82 [25.6%] in patients without CMV diseases, P=1.000). Median survival days in these 26 patients were 316 days (range 10-3032 days). Median survival time tend to be shorter in patients with CMV diseases compared to those without CMV diseases (median [range], 137[38-504] vs. 354 [10-3032], P=0.283) , however, it was statistically insignificant.

Conclusion: Given the high rate of CMV disease in the early post-HT period, prophylactic strategy may be considered as an option to prevent CMV disease-associated comorbidities in this critical period.

Young Eun Ha, MD1, Mi Kyoung Joung1, Yu Mi Wi, MD2, Cheol-In Kang, MD3, Doo Ryeon Chung, MD3, Jae-Hoon Song, MD3 and Kyong Ran Peck, MD1, (1)Samsung Medical Center, Seoul, South Korea, (2)Samsung Changwon Hospital, Changwon, South Korea, (3)Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Disclosures:

Y. E. Ha, None

M. K. Joung, None

Y. M. Wi, None

C. I. Kang, None

D. R. Chung, None

J. H. Song, None

K. R. Peck, None

Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.