Turk Gogus Kalp Damar Cerrahisi Derg. 2026 Jan 8;34(1):40-45. doi: 10.4274/tjtcs.2025.27341.
ABSTRACT
BACKGROUND: Cytomegalovirus (CMV) infection is a significant concern during the post-transplant period in heart transplant recipients. Both preemptive and prophylactic approaches are used to prevent CMV infection. This study evaluates the impact of these CMV-targeted strategies on infection rates and graft outcomes, reflecting real-world clinical experience.
METHODS: The prophylactic strategy was defined as initiating antiviral therapy in all at-risk recipients immediately post-transplantation. The preemptive strategy involved administering antiviral treatment only to patients with detected viremia, identified through regular virological monitoring.
RESULTS: CMV infection occurred in 50.0% (30/60) of patients in the preemptive group and 20.8% (5/24) in the prophylactic group, representing a statistically significant reduction with prophylaxis (p=0.014). Graft rejection occurred in 16.7% (10/60) of preemptive patients and 20.8% (5/24) of prophylactic patients, with no significant difference between the groups (p=0.652).
CONCLUSION: Prophylactic CMV prevention in heart transplant recipients significantly lowers the incidence of CMV infection compared to preemptive strategies. However, graft rejection rates did not differ significantly between the two approaches.
PMID:41527342 | DOI:10.4274/tjtcs.2025.27341