OKT3 Treatment for Allograft Rejection Is a Risk Factor for Cytomegalovirus Disease in Liver Transplantation

The role of OKT3 monoclonal antibody administration was studied as a risk factor for symptomatic cytomegalovirus (CMV) infection in 229 consecutive liver transplant recipients not receiving specificCMV prophylaxis. Twenty-six patients (11.4%) receivedOKT3 and 17 ofthem developed CMV infection, 11 (4...

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Published inThe Journal of infectious diseases Vol. 171; no. 4; pp. 1014 - 1018
Main Authors Portela, Daniel, Patel, Robin, Larson-Keller, Jeffrey J., Ilstrup, Duane M., Wiesner, Russell H., Steers, Jeffery L., Krom, Ruud A. F., Paya, Carlos V
Format Journal Article
LanguageEnglish
Published United States The University of Chicago Press 01.04.1995
University of Chicago Press
Subjects
Concise Communication
Cytomegalovirus
Cytomegalovirus infections
Cytomegalovirus Infections - blood
Cytomegalovirus Infections - etiology
Female
Graft rejection
Graft Rejection - therapy
Health care administration
Humans
Immunosuppression
Infections
Liver
Liver Transplantation
Lung Transplantation
Male
Methylprednisolone - therapeutic use
Multivariate Analysis
Muromonab-CD3 - adverse effects
Postoperative Complications - etiology
Predisposing factors
Risk Factors
Serology
Transplantation
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Summary:The role of OKT3 monoclonal antibody administration was studied as a risk factor for symptomatic cytomegalovirus (CMV) infection in 229 consecutive liver transplant recipients not receiving specificCMV prophylaxis. Twenty-six patients (11.4%) receivedOKT3 and 17 ofthem developed CMV infection, 11 (4.8%) being symptomatic. OKT3 use was a significant risk factor for symptomatic CMV infection by both univariate (relative risk [RR], 2.9; 95% confidence interval [CI], 1.5-5.8; P = .002) and multivariate time-dependent (RR, 3.4; 95% CI, 1.7-7.1; P = .001) analyses. A subgroup analysis revealed that OKT3 use was a significant risk factor for symptomatic CMV infection in CMV-seropositive but not seronegative recipients. OKT3 therapy for steroid-resistant rejection is a risk factor for symptomatic CMV infection in liver transplant recipients who are seropositive for CMV before transplantation. This group should be targeted for antiviral prophylaxis when OKT3 antirejection therapy is used.
Bibliography:istex:4934A0A13E6D72E5EFD464DAF7428F97A6D593BD
Reprints or correspondence: Dr. Carlos Y. Paya, Division of Infectious Diseases, Mayo Clinic, 200 First St. SW, 501 Guggenheim Bldg., Rochester, MN 55905.
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ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/171.4.1014