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Adverse Occurrence type:
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Retrospective review of 109 donor-positive/recipient-negative lung transplant patients who received alemtuzumab induction and valganciclovir for cytomegalovirus prophylaxis. Primary infection occured in 75 recipients: asymptomatic viremia developed in 45, CMV disease developed in 30. Five out of 30 recipients with CMV disease died as a direct result of the infection.
Demonstration of imputability or root cause:
Virologic monitoring (antigen shell assays or whole blood polymerase chain reaction). CMV mismatch (D+/R-). No other potential sources of CMV infection were taken into consideration. While not enough information to meet definition of "proven" there are certainly many cases with imputability of "probable" given D+/R- and development of CMV despite prophylaxis.
Mitsani D, Nguyen MH, Kwak EJ, Silveira FP, et al. Cytomegalovirus disease among donor-positive/recipient-negative lung transplant recipients in the era of valganciclovir prophylaxis. J Heart Lung Transplant. 2010 Sep;29(9):1014-20.
Want to consolidate this with face transplant and with SOT general to make one record with several supporting papers. There doesn't appear to be anything unique regarding CMV transmission risk to warrant separate listings for different organs. ---------------------------------- First record for CMV transmission through lung transplantation in the library. Since there are different MPHOs involved it is necessary to create separate records (EP)