Heart transplant

How cytomegalovirus affects survival in heart transplant patients

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In a large study based on data from the International Society for Heart and Lung Transplantation (ISHLT) registry covering a total of 44,516 patients worldwide, an international team of researchers showed a significant correlation between the status of CMV antibodies from organ donors and reduced long-term survival of patients after heart transplantation. The team, led by Dr Christian Heim, Deputy Clinical Director of the Cardiac Surgery Department at Universitätsklinikum Erlangen, published their results in the journal Transplantation.

Heart Transplant Survival Study

Although a heart transplant greatly improves the long-term survival of patients, they do not live on average until twelve years after the operation. Despite the shortage of organ donors caused by a decline in the population’s willingness to donate organs, heart transplantation remains the preferred choice for the treatment of chronic heart failure. “Each year, far too many patients still die on the waiting list for a heart transplant. We must fight against the shortage of organ donors by intensifying our efforts to inform the general public, but at the same time, we must compensate for the shortage of organs by researching the processes of chronic rejection, which over time lead to the loss of organs. ‘transplant failure,’ says Dr Heim.

Cytomegalovirus usually goes unnoticed

During their lifetime, most adults are infected with cytomegalovirus (CMV), a herpes virus, without showing any symptoms. They then continue to carry the pathogen in their body, not knowing they have it. Previous animal experiments have already indicated that there is a link between CMV and allograft vasculopathy, a long-term complication that is the leading cause of organ rejection in patients. However, for a long time, the influence of the antibody constellation at the time of transplantation on the long-term survival of organ recipients remained uncertain.

A positive CMV antibody status leads to a more unfavorable outcome for the organ recipient

Now, this study based on a large group of patients has allowed researchers to prove that if donors have a positive CMV antibody status, it leads to a significantly worse outcome for organ recipients. “In this large registry study, we were able to show for the first time that there is a significant correlation between CMV status at the time of transplant and reduced life expectancy in heart transplant patients”, explains Philipp Müller , junior doctor in cardiac surgery.

Dr Heim adds, “We have been conducting fundamental research into cytomegaloviruses and their impact on clinical rejection of heart and lung transplants for over ten years now. We are happy that the results we got in experiments with small animals have now been confirmed. in this registry study. We will have to discuss whether this will influence the allocation of donor organs to certain patients in the future in national and international specialist associations.

The challenge of organ transplant rejection

More information:
Christian Heim et al, the seropositivity of cytomegalovirus donors negatively affects survival after heart transplantation, Transplantation (2021). DOI: 10.1097 / TP.0000000000003961

Provided by Friedrich-Alexander Erlangen-Nurnberg University

Quote: How Cytomegalovirus Affects Survival in Heart Transplant Patients (2021, December 8) Retrieved December 8, 2021 from https://medicalxpress.com/news/2021-12-cytomegalovirus-affects-survival-heart-transplant.html

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