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, Jaeckel, Elmar, Hau, Hans-Michael, Tsui, Tung Yu, Perrakis, Aristoteles, Schlitt, Hans-Juergen, Herzer, Kerstin and Tacke, Frank (2020). Prevention and Management of CMV Infections after Liver Transplantation: Current Practice in German Transplant Centers. J. Clin. Med., 9 (8). BASEL: MDPI. ISSN 2077-0383

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Abstract

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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Engelmann, CorneliusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sterneck, MartinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weiss, Karl HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Templin, SilkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zopf, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Denk, GeraldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eurich, DennisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pratschke, JohannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weiss, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Welker, Martin-WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zimmermann, TimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knipper, PetraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nierhoff, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lorf, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jaeckel, ElmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hau, Hans-MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tsui, Tung YuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perrakis, AristotelesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlitt, Hans-JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herzer, KerstinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tacke, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-324437
DOI: 10.3390/jcm9082352
Journal or Publication Title: J. Clin. Med.
Volume: 9
Number: 8
Date: 2020
Publisher: MDPI
Place of Publication: BASEL
ISSN: 2077-0383
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VALGANCICLOVIR CYTOMEGALOVIRUS PROPHYLAXIS; INTERNATIONAL CONSENSUS GUIDELINES; DRUG-RESISTANT CYTOMEGALOVIRUS; PREEMPTIVE THERAPY; CLINICAL UTILITY; INTRAVENOUS GANCICLOVIR; ANTIVIRAL PROPHYLAXIS; ANTIGENEMIA ASSAY; ORAL GANCICLOVIR; DISEASEMultiple languages
Medicine, General & InternalMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32443

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