Trial Outcomes & Findings for A Study of Cytomegalovirus Disease Epidemiology in Pediatric and Adult Liver Transplant Recipients in China (NCT NCT05958186)

NCT ID: NCT05958186

Last Updated: 2026-04-13

Results Overview

Clinically significant CMV reactivation was defined as a positive CMV-DNA PCR or pp65 antigenemia test in the context of clinical symptoms attributable to CMV. CMV disease was defined as evidence of CMV infection with documented end-organ disease (e.g., CMV hepatitis, colitis, pneumonitis) according to established international guidelines.

Recruitment status

COMPLETED

Target enrollment

800 participants

Primary outcome timeframe

Within 12 months after liver transplantation

Results posted on

2026-04-13

Participant Flow

This investigation employed a prospective, observational cohort design conducted across six high-volume liver transplant centers in China: Shanghai General Hospital, Ruijin Hospital, The First Affiliated Hospital of Jilin University, The First Affiliated Hospital of Zhengzhou University, West China Hospital, and Tianjin First Central Hospital. Recruitment occurred between August 2023 and June 2024, with a 12-month follow-up period for each participant concluding in June 2025.

A total of 1020 consecutive liver transplant recipients were screened for eligibility. Of these, 220 patients did not meet the inclusion criteria or declined to participate. Therefore, 800 patients were enrolled and constituted the study cohort

Participant milestones

Participant milestones
Measure
Prophylaxis Strategy Cohort
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
Overall Study
STARTED
320
310
170
Overall Study
COMPLETED
315
305
166
Overall Study
NOT COMPLETED
5
5
4

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A Study of Cytomegalovirus Disease Epidemiology in Pediatric and Adult Liver Transplant Recipients in China

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Prophylaxis Strategy Cohort
n=320 Participants
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
n=310 Participants
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
n=170 Participants
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
Total
n=800 Participants
Total of all reporting groups
Age, Continuous
41.5 year
STANDARD_DEVIATION 18.2 • n=193 Participants
43.1 year
STANDARD_DEVIATION 19.5 • n=193 Participants
39.8 year
STANDARD_DEVIATION 17.6 • n=386 Participants
41.8 year
STANDARD_DEVIATION 18.6 • n=112 Participants
Sex: Female, Male
Female
128 Participants
n=193 Participants
112 Participants
n=193 Participants
65 Participants
n=386 Participants
305 Participants
n=112 Participants
Sex: Female, Male
Male
192 Participants
n=193 Participants
198 Participants
n=193 Participants
105 Participants
n=386 Participants
495 Participants
n=112 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=193 Participants
0 Participants
n=193 Participants
0 Participants
n=386 Participants
0 Participants
n=112 Participants
Race (NIH/OMB)
Asian
320 Participants
n=193 Participants
310 Participants
n=193 Participants
170 Participants
n=386 Participants
800 Participants
n=112 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=193 Participants
0 Participants
n=193 Participants
0 Participants
n=386 Participants
0 Participants
n=112 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=193 Participants
0 Participants
n=193 Participants
0 Participants
n=386 Participants
0 Participants
n=112 Participants
Race (NIH/OMB)
White
0 Participants
n=193 Participants
0 Participants
n=193 Participants
0 Participants
n=386 Participants
0 Participants
n=112 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=193 Participants
0 Participants
n=193 Participants
0 Participants
n=386 Participants
0 Participants
n=112 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=193 Participants
0 Participants
n=193 Participants
0 Participants
n=386 Participants
0 Participants
n=112 Participants
MELD score at transplant
22.5 units on a scale
n=193 Participants
21 units on a scale
n=193 Participants
23 units on a scale
n=386 Participants
22 units on a scale
n=112 Participants

PRIMARY outcome

Timeframe: Within 12 months after liver transplantation

Clinically significant CMV reactivation was defined as a positive CMV-DNA PCR or pp65 antigenemia test in the context of clinical symptoms attributable to CMV. CMV disease was defined as evidence of CMV infection with documented end-organ disease (e.g., CMV hepatitis, colitis, pneumonitis) according to established international guidelines.

Outcome measures

Outcome measures
Measure
Prophylaxis Strategy Cohort
n=320 Participants
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
n=310 Participants
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
n=170 Participants
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
Number of Participants With Clinically Significant CMV Reactivation or CMV Disease
CMV Infection
62 Participants
89 Participants
78 Participants
Number of Participants With Clinically Significant CMV Reactivation or CMV Disease
CMV Disease
32 Participants
58 Participants
56 Participants
Number of Participants With Clinically Significant CMV Reactivation or CMV Disease
Late-onset CMV
12 Participants
31 Participants
44 Participants

PRIMARY outcome

Timeframe: Within 12 months after liver transplantation

Population: 315 participants completed follow-up in prophylaxis group, 305 participants completed follow-up in preemptive group, and 166 participants completed follow-up in non-prevention group.

Participants were considered to have completed the study if they were alive and did not experience CMV reactivation requiring study closure, and provided data through the 12-month post-transplant visit.

Outcome measures

Outcome measures
Measure
Prophylaxis Strategy Cohort
n=320 Participants
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
n=310 Participants
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
n=170 Participants
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
Number of Participants Who Completed the 12-Month Follow-up
315 Participants
305 Participants
166 Participants

PRIMARY outcome

Timeframe: Within 12 months after liver transplantation

The occurrence of death from any cause within 12 months post-transplantation. As this was an observational study, mortality was assessed as an efficacy outcome (to calculate survival probability) rather than a solicited adverse event. Deaths were identified through scheduled study follow-ups, review of medical records, and when necessary, verification with civil registries.

Outcome measures

Outcome measures
Measure
Prophylaxis Strategy Cohort
n=320 Participants
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
n=310 Participants
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
n=170 Participants
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
All-Cause Mortality
16 Participants
16 Participants
13 Participants

SECONDARY outcome

Timeframe: Within 12 months after liver transplantation

Population: Five participants lost to follow-up in prophylaxis group, five participants lost to follow-up in preemptive group, and four participants lost to follow-up in non-prevention group.

Participants were considered lost to follow-up if they could not be contacted for scheduled study visits or assessments despite multiple attempts, and no outcome data could be obtained after their last contact.

Outcome measures

Outcome measures
Measure
Prophylaxis Strategy Cohort
n=320 Participants
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
n=310 Participants
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
n=170 Participants
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
Number of Participants Lost to Follow-up
5 Participants
5 Participants
4 Participants

SECONDARY outcome

Timeframe: Within 12 months after liver transplantation

Population: Non of participants asked to withdraw.

During follow-up, participants refuse to keep this study within 12 months after liver transplantation

Outcome measures

Outcome measures
Measure
Prophylaxis Strategy Cohort
n=320 Participants
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
n=310 Participants
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
n=170 Participants
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
Participants Asked to Withdraw
0 Participants
0 Participants
0 Participants

Adverse Events

Prophylaxis Strategy Cohort

Serious events: 55 serious events
Other events: 0 other events
Deaths: 16 deaths

Preemptive Strategy Cohort

Serious events: 60 serious events
Other events: 0 other events
Deaths: 16 deaths

No Prevention Strategy Cohort

Serious events: 40 serious events
Other events: 0 other events
Deaths: 13 deaths

Serious adverse events

Serious adverse events
Measure
Prophylaxis Strategy Cohort
n=320 participants at risk
Consecutive patients receiving universal antiviral prophylaxis as the standard-of-care CMV prevention strategy post-transplant.
Preemptive Strategy Cohort
n=310 participants at risk
Consecutive patients managed with a preemptive therapy strategy (monitoring and treatment upon viremia) post-transplant.
No Prevention Strategy Cohort
n=170 participants at risk
Consecutive patients who did not receive systematic universal prophylaxis or preemptive therapy for CMV post-transplant.
General disorders
Serious adverse events leading to hospitalization or graft loss
17.2%
55/320 • Number of events 55 • From enrollment until end of follow-up, up to 12 months
As an observational study, the protocol did not mandate solicitation of all adverse events. However, mortality (all-cause death) and serious adverse events leading to hospitalization or graft loss were actively collected as part of the study outcomes. Other non-serious adverse events were not systematically collected.
19.4%
60/310 • Number of events 60 • From enrollment until end of follow-up, up to 12 months
As an observational study, the protocol did not mandate solicitation of all adverse events. However, mortality (all-cause death) and serious adverse events leading to hospitalization or graft loss were actively collected as part of the study outcomes. Other non-serious adverse events were not systematically collected.
23.5%
40/170 • Number of events 40 • From enrollment until end of follow-up, up to 12 months
As an observational study, the protocol did not mandate solicitation of all adverse events. However, mortality (all-cause death) and serious adverse events leading to hospitalization or graft loss were actively collected as part of the study outcomes. Other non-serious adverse events were not systematically collected.

Other adverse events

Adverse event data not reported

Additional Information

LZhong

Shanghai1st

Phone: +8617317371083

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place