Andre C. Kalil, MD; Josh Levitsky, MD; Elizabeth Lyden, MS; Julie Stoner, PhD; Alison G. Freifeld, MD
Acknowledgments: The authors thank Elaine Litton for providing outstanding administrative support and Patricia A. Kalil for critical review of the manuscript.
Grant Support: None.
Potential Financial Conflicts of Interest: Consultancies: A.G. Freifeld (Enzon); Honoraria: A.G. Freifeld (Pfizer Inc., Enzon, Merck & Co. Inc.); Grants received: A.G. Freifeld (Ortho-McNeil); Grants pending: A.G. Freifeld (Astellas).
Requests for Single Reprints: Andre C. Kalil, MD, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198-5400; e-mail, email@example.com.
Current Author Addresses: Drs. Kalil and Freifeld: University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198-5400.
Dr. Levitsky: Northwestern Memorial Hospital, 303 East Chicago Avenue, Chicago, IL 60611.
Ms. Lyden and Dr. Stoner: University of Nebraska Medical Center, 985350 Nebraska Medical Center, Omaha, NE 68198-4350.
Author Contributions: Conception and design: A.C. Kalil. Analysis and interpretation of the data: A.C. Kalil, J. Levitsky, E. Lyden, J. Stoner, A.G. Freifeld. Drafting of the article: A.C. Kalil, E. Lyden, J. Stoner, A.G. Freifeld. Critical revision of the article for important intellectual content: A.C. Kalil, J. Levitsky, E. Lyden, J. Stoner, A.G. Freifeld. Final approval of the article: A.C. Kalil, J. Levitsky, E. Lyden, J. Stoner, A.G. Freifeld. Statistical expertise: E. Lyden, J. Stoner. Collection and assembly of data: A.C. Kalil, J. Levitsky.
Kalil AC, Levitsky J, Lyden E, Stoner J, Freifeld AG. Meta-Analysis: The Efficacy of Strategies To Prevent Organ Disease by Cytomegalovirus in Solid Organ Transplant Recipients. Ann Intern Med. 2005;143:870-880. doi: 10.7326/0003-4819-143-12-200512200-00005
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Published: Ann Intern Med. 2005;143(12):870-880.
Cytomegalovirus is a common opportunistic infection among recipients of organ transplants.
This meta-analysis summarizes 17 randomized trials of antiviral therapy for recipients of liver and kidney allografts. Universal prophylaxis for all high-risk patients and preemptive treatment for patients who had the virus detected during periodic monitoring reduced cytomegalovirus organ disease and allograft rejection more than did no treatment or placebo. Only universal prophylaxis reduced bacterial and fungal infections and death.
Most trials were small and were not blinded.
Although the authors prefer universal prophylaxis over preemptive treatment, they recommend a large confirmatory trial to directly compare the 2 strategies.
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Hematology/Oncology, Infectious Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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