Efficacy of short-course ganciclovir in preventing cytomegalovirus infection after pediatric liver transplantation / 中华器官移植杂志

ABSTRACT

Objective:To explore the preventive efficacy of 2-week ganciclovir intravenous injection for CMV infection after pediatric liver transplantation(LT).Methods:Clinical data were retrospectively analyzed for 404 pediatric LT recipients from January 1, 2015 to December 31, 2017. According to whether or not ganciclovir was intravenously administered for preventing CMV infection, they were divided into two groups of prevention(235 cases)and non-prevention(169 cases). The preoperative, intraoperative and postoperative follow-up data of two groups were recorded. Survival rate, incidence of CMV infection and time of initial CMV infection were compared between two groups.Results:The median follow-up time of 404 pediatric liver transplantation recipients was 856 days and the incidence of CMV infection 39.1%. No inter-group statistical difference existed in such basic clinical data as gender, age, primary disease, preoperative PELD score, CHILD grade, operative duration, intraoperative blood loss, immunosuppressive regimen or rejection rate. The median follow-up time of two groups was 1014 and 731 days; The incidence of CMV infection 37.4%(88/235)and 41.4%(70/169); The average postoperative time of initial CMV infection 75.5 and 110.2 days; The rate of CMV re-infection after initial CMV infection 26.1%(23/88)and 18.6%(13/70)respectively. No significant inter-group differences existed( P>0.05). Conclusions:Early postoperative 2-week intravenous ganciclovir injection fails to reduce the incidence of CMV infection after pediatric LT, nor delay the occurrence time of CMV infection. It is not recommended as a preventive program for CMV infection after pediatric LT.