Date of Award

4-27-2015

Document Type

Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

David B. Banach, MD, MPH, MS

Abstract

Liver transplantation is a standard life-saving procedure that has changed the prognosis for infants and children with end-stage liver disease. Cytomegalovirus (CMV) is the most common infection that occurs after liver transplantation in pediatric patients, yet the standard of care for infection prevention remains unclear. We propose a prospective, randomized, multicenter trial to compare two CMV prevention strategies in high-risk pediatric patients, CMV-seronegative recipients receiving allografts from CMV-seropositive donors (D+/R-). Patients will be randomized into either the prophylaxis or preemptive arm, and receive valganciclovir treatment for duration designed to each cohort. Both cohorts will be evaluated at 180 days post-transplantation to determine presence of CMV disease and other adverse outcomes. Our study will be the first to directly compare the two CMV prevention strategies in children. It will help to establish a standard of care in pediatric liver transplant population, and improve patient survival rate and quality of life.

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