ArticleClinical transplantation2023
Incidence and severity of cytomegalovirus infection in seropositive heart transplant recipients.
Article in Clinical transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 17 citations in OpenAlex.
- Cytomegalovirus infections in thoracic organ transplant recipients: Updates on prevention, treatment, and immune monitoring.JHLT open · 2026Article
- Review
- CMV prevention in heart transplant recipients: Comparative analysis of preemptive and prophylactic strategies.Turk gogus kalp damar cerrahisi dergisi · 2026Article
- Antigenic-Specificity and Cytokine Profile of the T-Cell Response to Human Cytomegalovirus in Transplant Recipients.Pathogens (Basel, Switzerland) · 2026Article
- Diagnosis of EBV and HCMV infections in pediatric heart transplant recipients.BMC pediatrics · 2025Article
- Cytomegalovirus Encephalitis in a Heart Transplant Recipient Presenting With Behavioral Changes and Functional Neurologic Deficits.JACC. Case reports · 2025Article
- Low Absolute Lymphocyte Count Associated With Anti-Thymocyte Globulin Induction May Be a Predictor of Early Cytomegalovirus Infection in Pediatric Heart Transplantation.Pediatric transplantation · 2025Article
- Diagnosis of rejection following heart transplantation: diving into the future.Frontiers in transplantation · 2025Review
- Article
- Multicenter study of universal prophylaxis versus pre-emptive therapy for patients at intermediate risk (R+) for CMV following heart transplantation.Clinical transplantation · 2023Article
- Incidence and severity of cytomegalovirus infection in seropositive heart transplant recipients.Clinical transplantation · 2023Article
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe frequency and significance of cytomegalovirus (CMV) infection in seropositive (R+) heart transplant recipients (HTR) is unclear, with preventative recommendations mostly extrapolated from other groups. We evaluated the incidence and severity of CMV infection in R+ HTR, to identify risk factors and describe outcomes.
methodsR+ HTR from 2010 to 2019 were included. Antiviral prophylaxis was not routinely used, with clinically guided monitoring the local standard of care. The primary outcome was CMV infection within one-year post-transplant; secondary outcomes included other herpesvirus infections and mortality.
resultsCMV infection occurred in 27/155 (17%) R+ HTR. Patients with CMV had a longer hospitalization (27 vs. 20 days, unadjusted HR 1.02, 95% CI 1.00-1.02, p = .01), higher rate of intensive care readmission (26% vs. 9%, unadjusted HR 3.46, 1.46-8.20, p = .005), and increased mortality (33% vs. 8%, unadjusted HR 10.60, 4.52-24.88, p < .001). The association between CMV and death persisted after adjusting for multiple confounders (HR 24.19, 95% CI 7.47-78.30, p < .001). Valganciclovir prophylaxis was used in 35/155 (23%) and was protective against CMV (infection rate 4% vs. 27%, adjusted HR .07, .01-.72, p = .025), even though those receiving it were more likely to have received thymoglobulin (adjusted OR 10.5, 95% CI 2.01-55.0, p = .005).
conclusionsCMV infection is common in R+ HTR and is associated with a high burden of disease and increased mortality. Patients who received valganciclovir prophylaxis were less likely to develop CMV infection, despite being at higher risk. These findings support the routine use of antiviral prophylaxis following heart transplantation in all CMV R+ patients.
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