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Transplantation. 2009 Jun 15;87(11):1720-6. doi: 10.1097/TP.0b013e3181a60b4e.

Cytomegalovirus DNA load patterns developing after lung transplantation are significantly correlated with long-term patient survival.

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  • 1Institute of Clinical Virology, Medical University of Vienna, Vienna, Austria.

Abstract

BACKGROUND:

Cytomegalovirus (CMV) causes complications after lung transplantation (LuTX). We have investigated whether patient survival is associated with CMV DNA load patterns developing in EDTA-plasma and bronchoalveolar lavage (BAL) during the first year after LuTX and whether patients' predispositions influence this development.

MATERIALS AND METHODS:

CMV DNA loads in plasma and BAL were investigated serially in 84 LuTX recipients. Various patient characteristics and variants in mannose-binding lectin and toll-like receptor 2 genes were analyzed. Patient survival beyond 1 year posttransplantation and influence of patient-specific factors on viral load development were assessed by Kaplan-Meier survival and Cox regression methods.

RESULTS:

Four distinct group patterns were observed: (a) less than 1000 copies CMV DNA/mL in plasma and BAL (42%); (b) more than 1000 copies/mL in BAL only (21%); (c) one limited episode (25%), or (d) more than one episode of more than 1000 copies/mL plasma (12%). The risk of death after the first year was elevated 14-fold in group D and sixfold in group B. CMV DNA load patterns were not associated with patient-specific factors except CMV-D+/R- status. Initial and peak plasma CMV DNA levels were significantly increased in group D.

CONCLUSIONS:

Active CMV replication that is not limited after one episode of CMV DNAemia leads to significantly decreased long-term survival after LuTX.

PMID:
19502966
[PubMed - indexed for MEDLINE]
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