Cytomegalovirus Prevention in Liver Transplant Recipients: A Comparative Study of Universal and Preemptive Strategies with Valganciclovir
| Author | Mohsen Aliakbarian | en |
| Author | Faezeh Majidianfar | en |
| Author | Seyed Sajjad Alavi Kakhki | en |
| Author | Saeed Javanshir | en |
| Author | Mandana Khodashahi | en |
| Author | Kambiz Akhavan Rezayat | en |
| Author | Maliheh Dadgar Moghadam | en |
| Author | Mahboobeh Ghasemzadeh Rahbardar | en |
| Author | Rozita Khodashahi | en |
| Orcid | Mohsen Aliakbarian [0000-0002-5186-7152] | en |
| Orcid | Seyed Sajjad Alavi Kakhki [0000-0001-8450-8175] | en |
| Orcid | Saeed Javanshir [0009-0000-2459-645X] | en |
| Orcid | Maliheh Dadgar Moghadam [0000-0002-4797-8714] | en |
| Orcid | Mahboobeh Ghasemzadeh Rahbardar [0000-0002-5491-572X] | en |
| Orcid | Rozita Khodashahi [0000-0002-5360-7426] | en |
| Accessioned Date | 2026-07-14T17:50:49Z | |
| Issued Date | 2026-02-28 | en |
| Abstract | Background and Objectives: Universal prophylaxis and preemptive therapy are established strategies to prevent cytomegalovirus (CMV) after liver transplantation, yet their real-world comparative performance varies by center and risk mix. Methods: We conducted a single-center retrospective cohort of consecutive adult recipients transplanted from 2013 - 2021 in Mashhad, Iran. Exposure was the CMV-prevention strategy received (universal valganciclovir prophylaxis vs preemptive PCR-based monitoring). Primary outcomes were CMV viremia (PCR-confirmed) and CMV disease (clinical/histologic). Secondary outcomes were late-onset CMV (> 100 days post-transplant), acute rejection, and mortality. Multivariable logistic regression (and Cox proportional hazards where event dates were available) adjusted for calendar era, donor/recipient serostatus (D/R), immunosuppression regimen, monitoring protocol, age, and sex. Results: Among 475 recipients (universal valganciclovir: 170; preemptive monitoring: 305), CMV viremia occurred in 10/170 (5.9%) vs 18/305 (5.9%) (P = 0.993). Among the 28 infected patients, 23 (82.1%) were male. Onset timing was < 1 month in 6 (21.4%), 1 - 3 months in 9 (32.1%), and > 6 months in 13 (46.4%), indicating late-onset (> 3 months) in 22/28 (78.6%) overall. Conclusions: In this cohort, universal prophylaxis and preemptive monitoring showed no significant adjusted differences in CMV infection or disease. Given era effects and center-specific practices, policy selection should consider D/R risk, monitoring logistics, and late-onset CMV risk. Multicenter studies are warranted. | en |
| DOI | https://doi.org/10.5812/archcid-158027 | en |
| URI | https://brieflands.com/journals/archcid/articles/158027 | en |
| URI | https://repository.brieflands.com/handle/123456789/67997 | |
| Keyword | Cytomegalovirus | en |
| Keyword | Liver Transplantation | en |
| Keyword | Valganciclovir | en |
| Keyword | Antiviral Prophylaxis | en |
| Keyword | Graft Rejection | en |
| Publisher | Brieflands | en |
| Title | Cytomegalovirus Prevention in Liver Transplant Recipients: A Comparative Study of Universal and Preemptive Strategies with Valganciclovir | en |
| Type | Research Article | en |
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