Cytomegalovirus prevention and long-term recipient and graft survival in pediatric heart transplant recipients.

摘要

INTRODUCTION: The association between cytomegalovirus (CMV) immune globulin (CMVIG) and clinical outcomes in pediatric heart transplantation has not been evaluated. Long-term recipient and graft survival were compared between pediatric heart recipients who received CMV prophylaxis with CMVIG (with or without antivirals), antivirals without CMVIG, and no prophylaxis. CMVIG (with or without antivirals) versus no prophylaxis was also assessed in the CMV-positive donor/CMV-negative recipient cohort. METHODS: Data from the Scientific Registry of Transplant Recipients included patients with a transplant date between January 1995 and October 2008; follow-up data were through March 2009. All pediatric (younger than 18 years) recipients of primary, single-organ heart transplants were included. Kaplan-Meier analysis was used to examine rates of recipient death and graft loss at 7 years posttransplantation. Cox proportional hazards regression was used to estimate adjusted risk for graft loss and death. RESULTS: CMVIG (with or without antivirals) and antivirals without CMVIG were both associated with significantly (P