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Risk Factors for Cytomegalovirus Reactivation in Lung Transplant Recipients

  • LUNG TRANSPLANTATION
  • Published:
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Abstract

Purpose

We examined risk factors that may have contributed to Cytomegalovirus (CMV) reactivation among patients who underwent lung transplantation (LTx).

Methods

We reviewed medical records of patients who underwent LTx at a tertiary healthcare hospital in South Korea between January 2013 and May 2017. We excluded patients who died within the first year after LTx and those lost to follow-up. CMV reactivation was defined as the detection of CMV titers above 3000 copies/ml regardless of specific symptoms after prophylaxis cessation.

Results

Of 89 patients included, 39 (43.8%) developed CMV reactivation. Of those 39 patients, 16 (41.0%) experienced additional CMV reactivation. Multivariate analysis identified lymphocyte counts below 1.0 × 103/μl (hazard ratio [HR] 49.33, p < 0.001) and use of steroids at more than twice the standard dose (HR 8.07, p < 0.001) as risk factors for CMV reactivation. The multivariate model also identified chronic kidney disease (CKD; HR 5.19, p = 0.016) and pneumonia (HR 17.22, p = 0.013) as risk factors for repetitive CMV reactivation.

Conclusion

This study suggests that lymphopenia and high doses of steroids may be important risk factors for CMV reactivation in LTx patients. Our results also suggest that repetitive CMV reactivation may be associated with CKD and pneumonia.

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Data Availability

Available on request.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun–gu, Seoul, 03722, Republic of Korea

    Se Hyun Kwak, Su Hwan Lee, Moo Suk Park, Young Sam Kim, Joon Chang & Song Yee Kim

  2. Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jin Gu Lee & Hyo Chae Paik

  3. Division of Infectious Diseases, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Su Jin Jeong

Authors
  1. Se Hyun Kwak
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  2. Su Hwan Lee
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  3. Moo Suk Park
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  4. Su Jin Jeong
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  5. Jin Gu Lee
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  6. Hyo Chae Paik
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  7. Young Sam Kim
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  8. Joon Chang
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  9. Song Yee Kim
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Corresponding author

Correspondence to Song Yee Kim.

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Conflict of interest

The authors declare no competing interests.

Ethical Approval

The Institutional Review Board at Severance Hospital approved this study (IRB No.2013-0522-031).

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Kwak, S.H., Lee, S.H., Park, M.S. et al. Risk Factors for Cytomegalovirus Reactivation in Lung Transplant Recipients. Lung 198, 829–838 (2020). https://doi.org/10.1007/s00408-020-00380-z

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  • DOI: https://doi.org/10.1007/s00408-020-00380-z

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