Survey of Post-Prophylaxis Delayed-Onset Cytomegalovirus Management Strategies Among Transplant Providers

Lemuel R Non; Chen Sabrina Tan; Dilek Ince; Raymund R Razonable

doi:10.1111/ctr.70015

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Survey of Post-Prophylaxis Delayed-Onset Cytomegalovirus Management Strategies Among Transplant Providers

Journal article

Open access

Peer reviewed

Survey of Post-Prophylaxis Delayed-Onset Cytomegalovirus Management Strategies Among Transplant Providers

Lemuel R Non, Chen Sabrina Tan, Dilek Ince and Raymund R Razonable

Clinical transplantation, Vol.38(11), e70015

11/2024

DOI: 10.1111/ctr.70015

PMID: 39476330

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Abstract

Preventive strategies for cytomegalovirus (CMV) in the posttransplant period have changed the pattern of CMV infections, now more commonly manifesting as late-onset occurrences known as post-prophylaxis delayed-onset CMV disease (PPDOC). We conducted a survey to investigate provider practices in managing PPDOC. A web-based provider survey on the management of PPDOC was developed using Research Electronic Data Capture (REDCap). It was distributed to the online forums of the American Society of Transplantation communities of practice (COP) for Infectious Diseases (IDCOP), Kidney and Pancreas (KPCOP), Liver and Intestinal (LICOP), and Thoracic and Critical Care (TCCOP). The survey was posted twice within a span of a month. Fifty-six respondents, comprising 50 (89%) transplant physicians and 6 (11%) transplant pharmacists, from 46 distinct transplant centers, completed the survey. Universal antiviral prophylaxis (UAP) was the predominant preventive approach for both high-risk (85%) and moderate-risk (85%) transplant recipients. Out of 56, 51 respondents completed the questions regarding management of PPDOC. Regular surveillance with nucleic acid amplification tests (NAAT) (88%) was the most commonly used approach in high-risk recipients, while symptom monitoring (73%) was the most common strategy in moderate-risk recipients. Immunologic monitoring was used only by a few respondents who found it moderately useful in high-risk recipients. Management of PPDOC was highly variable among providers and strategies differed based on patient risk profile. These findings could help shape future studies and guidelines to harmonize CMV management.

Antiviral Agents - therapeutic use

Cytomegalovirus - isolation & purification

Cytomegalovirus Infections - prevention & control

Cytomegalovirus Infections - virology

Disease Management

Female

Follow-Up Studies

Graft Rejection - etiology

Graft Rejection - prevention & control

Humans

Male

Organ Transplantation - adverse effects

Post-Exposure Prophylaxis

Postoperative Complications - prevention & control

Practice Patterns, Physicians' - statistics & numerical data

Prognosis

Surveys and Questionnaires

UIOWA OA Agreement

Details

Title: Subtitle: Survey of Post-Prophylaxis Delayed-Onset Cytomegalovirus Management Strategies Among Transplant Providers
Creators: Lemuel R Non - University of Iowa, Infectious Diseases
Chen Sabrina Tan - University of Iowa
Dilek Ince - University of Iowa
Raymund R Razonable - Mayo Clinic in Florida
Resource Type: Journal article
Publication Details: Clinical transplantation, Vol.38(11), e70015
Publisher: Wiley; HOBOKEN
DOI: 10.1111/ctr.70015
PMID: 39476330
ISSN: 1399-0012
eISSN: 1399-0012
Language: English
Date published: 11/2024
Academic Unit: Microbiology and Immunology; Infectious Diseases; Iowa Neuroscience Institute; Internal Medicine
Record Identifier: 9984740856702771

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