Although cytomegalovirus (CMV) is a common complication after pediatric liver transplantation (PLT), the optimal method for CMV prevention is uncertain and lacks multicentered investigation. We compared the effectiveness of short (<120 days) vs long (>180 days) CMV primary antiviral prophylaxis to prevent CMV disease in PLT, through a prospective cohort study of primary PLT (aged <18 years) recipients enrolled in the Society of Pediatric Liver Transplantation registry from 2015 to 2019 with either donor or recipient CMV seropositivity. Participants were grouped into short or long prophylaxis based on their center’s practice and intended duration. In total, 199 PLT recipients were enrolled including 112 (56.3%) short and 87 (43.7%) long prophylaxis. End-organ disease was rare and similar between groups (2.7% and 1.1%; P = .45). CMV DNAemia and syndrome were more common in the short compared with those in long prophylaxis (26.8% vs 13.8%; P = .03; 18.8% vs 6.9%; P = .02). Neutropenia occurred more commonly with long prophylaxis (55.2% vs 16.1%; P < .001). Graft and patient survival were similar. Consideration of a short prophylaxis must weigh increased risk of CMV syndrome/DNAemia against medication burden and neutropenia of longer prophylaxis.

中文翻译：

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儿科肝移植中的巨细胞病毒预防：儿科肝移植协会联盟的策略比较


尽管巨细胞病毒 （CMV） 是小儿肝移植 （PLT） 后的常见并发症，但预防 CMV 的最佳方法尚不确定，并且缺乏多中心调查。我们通过一项前瞻性队列研究，比较了短期 （<120 天） 与长期 （<180 天） CMV 一级抗病毒预防预防 PLT 中 PLV 疾病的有效性，该研究纳入了 2015 年至 2019 年在儿科肝移植学会登记处登记的原发性 PLT （年龄 <18 岁） 受者，供体或受体 CMV 血清阳性。参与者根据其中心的实践和预期持续时间分为短期或长期预防。总共招募了 199 名 PLT 受者，包括 112 名 （56.3%） 短期预防和 87 名 （43.7%） 长期预防。终末器官疾病罕见且组间相似 （2.7% 和 1.1%;P = .45）。与长期预防相比，CMV DNA 血症和综合征在短期中更常见 （26.8% vs 13.8%;P = .03;18.8% 对 6.9%;P = .02）。中性粒细胞减少症在长期预防中更常见 （55.2% vs 16.1%;P < .001）.移植物和患者生存率相似。考虑短期预防必须权衡 CMV 综合征/DNA 血症风险增加与长期预防的药物负担和中性粒细胞减少。