PMID- 19889123
OWN - NLM
STAT- MEDLINE
DCOM- 20100304
LR  - 20230124
IS  - 1600-6143 (Electronic)
IS  - 1600-6135 (Linking)
VI  - 10
IP  - 1
DP  - 2010 Jan
TI  - Clinical predictors of relapse after treatment of primary gastrointestinal 
      cytomegalovirus disease in solid organ transplant recipients.
PG  - 157-61
LID - 10.1111/j.1600-6143.2009.02861.x [doi]
AB  - Primary gastrointestinal cytomegalovirus (CMV) disease after solid organ 
      transplantation (SOT) is difficult to treat and may relapse. Herein, we reviewed 
      the clinical records of CMV D+/R- SOT recipients with biopsy-proven 
      gastrointestinal CMV disease to determine predictors of relapse. The population 
      consisted of 26 kidney (13 [50%]), liver (10 [38%]) and heart (3 [12%]) 
      transplant recipients who developed gastrointestinal CMV disease at a median of 
      54 (interquartile range [IQR]: 40-70) days after stopping antiviral prophylaxis. 
      Except for one patient, all received induction intravenous ganciclovir 
      (mean+/-SD, 33.8+/-19.3 days) followed by valganciclovir (27.5+/-13.3 days) in 18 
      patients. Ten patients further received valganciclovir maintenance therapy 
      (41.6+/-28.6 days). The median times to CMV PCR negativity in blood was 22.5 days 
      (IQR: 16.5-30.7) and to normal endoscopic findings was 27.0 days (IQR: 
      21.0-33.5). CMV relapse, which occurred in seven (27%) patients, was 
      significantly associated with extensive disease (p=0.03). CMV seroconversion, 
      viral load, treatment duration, maintenance therapy and endoscopic findings at 
      the end of therapy were not significantly associated with CMV relapse. In 
      conclusion, an extensive involvement of the gastrointestinal tract was 
      significantly associated with CMV relapse. However, endoscopic evidence of 
      resolution of gastrointestinal disease did not necessarily translate into a lower 
      risk of CMV relapse.
FAU - Eid, A J
AU  - Eid AJ
AD  - Division of Infectious Diseases, The William J von Liebig Transplant Center, 
      College of Medicine, Mayo Clinic, Rochester, Minnesota, MN, USA.
FAU - Arthurs, S K
AU  - Arthurs SK
FAU - Deziel, P J
AU  - Deziel PJ
FAU - Wilhelm, M P
AU  - Wilhelm MP
FAU - Razonable, R R
AU  - Razonable RR
LA  - eng
PT  - Journal Article
DEP - 20091104
PL  - United States
TA  - Am J Transplant
JT  - American journal of transplantation : official journal of the American Society of 
      Transplantation and the American Society of Transplant Surgeons
JID - 100968638
RN  - 0 (Antiviral Agents)
RN  - GCU97FKN3R (Valganciclovir)
RN  - P9G3CKZ4P5 (Ganciclovir)
SB  - IM
MH  - Adult
MH  - Antiviral Agents/*therapeutic use
MH  - Cohort Studies
MH  - Cytomegalovirus/genetics/isolation & purification
MH  - Cytomegalovirus Infections/*drug therapy/*etiology/transmission/virology
MH  - Female
MH  - Ganciclovir/analogs & derivatives/therapeutic use
MH  - Gastrointestinal Diseases/*drug therapy/*etiology/virology
MH  - Heart Transplantation/adverse effects
MH  - Humans
MH  - Kidney Transplantation/adverse effects
MH  - Liver Transplantation/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Polymerase Chain Reaction
MH  - Prognosis
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Transplants/*adverse effects/*virology
MH  - Valganciclovir
MH  - Viral Load/drug effects
MH  - Viremia/drug therapy/etiology/virology
EDAT- 2009/11/06 06:00
MHDA- 2010/03/05 06:00
CRDT- 2009/11/06 06:00
PHST- 2009/11/06 06:00 [entrez]
PHST- 2009/11/06 06:00 [pubmed]
PHST- 2010/03/05 06:00 [medline]
AID - S1600-6135(22)19553-5 [pii]
AID - 10.1111/j.1600-6143.2009.02861.x [doi]
PST - ppublish
SO  - Am J Transplant. 2010 Jan;10(1):157-61. doi: 10.1111/j.1600-6143.2009.02861.x. 
      Epub 2009 Nov 4.