GCV/VCVG prophylaxis against CMV DNAemia in pediatric renal transplant patients: A systematic review and meta‐analysis
CMV disease continues to stand as a significant threat to the longevity of renal transplants in children. More pediatric recipients are CMV‐negative with CMV‐positive donor serologies resulting in a HR mismatch. The length of prophylaxis with GCV or VGCV required to optimally prevent recurrence of C...
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| Veröffentlicht in: | Pediatric transplantation 2019-09, Vol.23 (6), p.e13514-n/a |
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| container_title | Pediatric transplantation |
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| creator | Chatani, Brandon Glaberson, Wendy Nemeth, Zsuzsanna Tamariz, Leonardo Gonzalez, Ivan A. |
| description | CMV disease continues to stand as a significant threat to the longevity of renal transplants in children. More pediatric recipients are CMV‐negative with CMV‐positive donor serologies resulting in a HR mismatch. The length of prophylaxis with GCV or VGCV required to optimally prevent recurrence of CMVDNAemia remains unknown. This study is a meta‐analysis comparing GCV/VGCV prophylaxis regimens provided for |
| doi_str_mv | 10.1111/petr.13514 |
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More pediatric recipients are CMV‐negative with CMV‐positive donor serologies resulting in a HR mismatch. The length of prophylaxis with GCV or VGCV required to optimally prevent recurrence of CMVDNAemia remains unknown. This study is a meta‐analysis comparing GCV/VGCV prophylaxis regimens provided for <6 months, from 6 to <12 months, and ≥12 months after transplant in order to prevent CMVDNAemia. The search conducted involved PubMed, EMBASE, ISI Web of Science, and Cochrane Central Register from inception through December 2017. Search terms Kidney Transplantation, CMV, GCV, and VGCV provided 204 studies for review. Studies excluded were those which did not itemize pediatric data separately, single case reports, and duplicate studies. Pooled analysis of five retrospective studies and one prospective study identified that there is no statistically significant difference in the incidence of CMV DNAemia when comparing <6 months of prophylaxis and >12 months of prophylaxis (23% and 15%, respectively, P = 0.23). Regardless of the length of prophylaxis, there was no statistical difference in the incidence of CMV DNAemia in the HR patients (6 to <12 months vs <6 months, P = 0.62; 6 to <12 months vs ≥12 months, P = 0.78; ≥12 months vs <6 months, P = 0.83). This study identifies no optimal length of prophylaxis for HR mismatch pediatric renal transplant patients as many develop CMV DNAemia.]]></description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/petr.13514</identifier><identifier>PMID: 31210393</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Case reports ; cytomegalovirus ; infectious risk ; Kidney transplantation ; Kidney transplants ; Meta-analysis ; pediatric kidney transplant ; pediatric kidney transplantation ; pediatric transplantation ; Pediatrics ; Prophylaxis ; Statistical analysis ; Studies ; Transplants & implants</subject><ispartof>Pediatric transplantation, 2019-09, Vol.23 (6), p.e13514-n/a</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3574-560d6b217b35b1161fb2c1a703f7ea5a748aef5b8f383bc9ec099eedc32109263</citedby><cites>FETCH-LOGICAL-c3574-560d6b217b35b1161fb2c1a703f7ea5a748aef5b8f383bc9ec099eedc32109263</cites><orcidid>0000-0002-6584-7048</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpetr.13514$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpetr.13514$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31210393$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chatani, Brandon</creatorcontrib><creatorcontrib>Glaberson, Wendy</creatorcontrib><creatorcontrib>Nemeth, Zsuzsanna</creatorcontrib><creatorcontrib>Tamariz, Leonardo</creatorcontrib><creatorcontrib>Gonzalez, Ivan A.</creatorcontrib><title>GCV/VCVG prophylaxis against CMV DNAemia in pediatric renal transplant patients: A systematic review and meta‐analysis</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description><![CDATA[CMV disease continues to stand as a significant threat to the longevity of renal transplants in children. More pediatric recipients are CMV‐negative with CMV‐positive donor serologies resulting in a HR mismatch. The length of prophylaxis with GCV or VGCV required to optimally prevent recurrence of CMVDNAemia remains unknown. This study is a meta‐analysis comparing GCV/VGCV prophylaxis regimens provided for <6 months, from 6 to <12 months, and ≥12 months after transplant in order to prevent CMVDNAemia. The search conducted involved PubMed, EMBASE, ISI Web of Science, and Cochrane Central Register from inception through December 2017. Search terms Kidney Transplantation, CMV, GCV, and VGCV provided 204 studies for review. Studies excluded were those which did not itemize pediatric data separately, single case reports, and duplicate studies. Pooled analysis of five retrospective studies and one prospective study identified that there is no statistically significant difference in the incidence of CMV DNAemia when comparing <6 months of prophylaxis and >12 months of prophylaxis (23% and 15%, respectively, P = 0.23). Regardless of the length of prophylaxis, there was no statistical difference in the incidence of CMV DNAemia in the HR patients (6 to <12 months vs <6 months, P = 0.62; 6 to <12 months vs ≥12 months, P = 0.78; ≥12 months vs <6 months, P = 0.83). This study identifies no optimal length of prophylaxis for HR mismatch pediatric renal transplant patients as many develop CMV DNAemia.]]></description><subject>Case reports</subject><subject>cytomegalovirus</subject><subject>infectious risk</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>Meta-analysis</subject><subject>pediatric kidney transplant</subject><subject>pediatric kidney transplantation</subject><subject>pediatric transplantation</subject><subject>Pediatrics</subject><subject>Prophylaxis</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Transplants & implants</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kc1O3DAQx62qqMDSSx-gstRLhRTwxM5Xb6sUFiS-hGCv0SSZtEZJNtheIDcegWfkSfCy0EMP-DLW6Dc_zejP2DcQe-Df_kDO7IGMQH1iWyCzLJBCxZ9f_0kgQYWbbNvaGyEgVqn6wjYlhCBkJrfYwyyf78_z-YwPZjH8HVt80JbjH9S9dTw_nfPfZ1PqNHLd84Fqjc7oihvqseXOYG-HFnvHB3Saemd_8Sm3o3XU-caKu9N0z7GveUcOnx-f0A-OVtsdttFga-nrW52w68ODq_woODmfHefTk6CSUaKCKBZ1XIaQlDIqAWJoyrACTIRsEsIIE5UiNVGZNjKVZZVRJbKMqK6kvzALYzlhP9def9_tkqwrOm0rav3WtFjaIgxVmIKKvXHCfvyH3iyWxu-7opIkUhBHylO7a6oyC2sNNcVgdIdmLEAUqzyKVR7Fax4e_v6mXJYd1f_Q9wA8AGvgXrc0fqAqLg6uLtfSFwZ7lmI</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Chatani, Brandon</creator><creator>Glaberson, Wendy</creator><creator>Nemeth, Zsuzsanna</creator><creator>Tamariz, Leonardo</creator><creator>Gonzalez, Ivan A.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6584-7048</orcidid></search><sort><creationdate>201909</creationdate><title>GCV/VCVG prophylaxis against CMV DNAemia in pediatric renal transplant patients: A systematic review and meta‐analysis</title><author>Chatani, Brandon ; Glaberson, Wendy ; Nemeth, Zsuzsanna ; Tamariz, Leonardo ; Gonzalez, Ivan A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3574-560d6b217b35b1161fb2c1a703f7ea5a748aef5b8f383bc9ec099eedc32109263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Case reports</topic><topic>cytomegalovirus</topic><topic>infectious risk</topic><topic>Kidney transplantation</topic><topic>Kidney transplants</topic><topic>Meta-analysis</topic><topic>pediatric kidney transplant</topic><topic>pediatric kidney transplantation</topic><topic>pediatric transplantation</topic><topic>Pediatrics</topic><topic>Prophylaxis</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chatani, Brandon</creatorcontrib><creatorcontrib>Glaberson, Wendy</creatorcontrib><creatorcontrib>Nemeth, Zsuzsanna</creatorcontrib><creatorcontrib>Tamariz, Leonardo</creatorcontrib><creatorcontrib>Gonzalez, Ivan A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chatani, Brandon</au><au>Glaberson, Wendy</au><au>Nemeth, Zsuzsanna</au><au>Tamariz, Leonardo</au><au>Gonzalez, Ivan A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>GCV/VCVG prophylaxis against CMV DNAemia in pediatric renal transplant patients: A systematic review and meta‐analysis</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2019-09</date><risdate>2019</risdate><volume>23</volume><issue>6</issue><spage>e13514</spage><epage>n/a</epage><pages>e13514-n/a</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract><![CDATA[CMV disease continues to stand as a significant threat to the longevity of renal transplants in children. More pediatric recipients are CMV‐negative with CMV‐positive donor serologies resulting in a HR mismatch. The length of prophylaxis with GCV or VGCV required to optimally prevent recurrence of CMVDNAemia remains unknown. This study is a meta‐analysis comparing GCV/VGCV prophylaxis regimens provided for <6 months, from 6 to <12 months, and ≥12 months after transplant in order to prevent CMVDNAemia. The search conducted involved PubMed, EMBASE, ISI Web of Science, and Cochrane Central Register from inception through December 2017. Search terms Kidney Transplantation, CMV, GCV, and VGCV provided 204 studies for review. Studies excluded were those which did not itemize pediatric data separately, single case reports, and duplicate studies. Pooled analysis of five retrospective studies and one prospective study identified that there is no statistically significant difference in the incidence of CMV DNAemia when comparing <6 months of prophylaxis and >12 months of prophylaxis (23% and 15%, respectively, P = 0.23). Regardless of the length of prophylaxis, there was no statistical difference in the incidence of CMV DNAemia in the HR patients (6 to <12 months vs <6 months, P = 0.62; 6 to <12 months vs ≥12 months, P = 0.78; ≥12 months vs <6 months, P = 0.83). This study identifies no optimal length of prophylaxis for HR mismatch pediatric renal transplant patients as many develop CMV DNAemia.]]></abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31210393</pmid><doi>10.1111/petr.13514</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-6584-7048</orcidid></addata></record> |
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| subjects | Case reports cytomegalovirus infectious risk Kidney transplantation Kidney transplants Meta-analysis pediatric kidney transplant pediatric kidney transplantation pediatric transplantation Pediatrics Prophylaxis Statistical analysis Studies Transplants & implants |
| title | GCV/VCVG prophylaxis against CMV DNAemia in pediatric renal transplant patients: A systematic review and meta‐analysis |
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