Table 1

Study characteristics

Author, yearCountryStudy designPopulationPre-emptive therapy/ prophylaxisProphylaxis/ pre-emptive medicationComparisonSample sizeDurationFollow-upSummary assessment of risk of bias
CYTOMEGALVIRUS PROPHYLAXIS/PRE-EMPTIVE THERAPY
Humar et al, 201015 24 Australia, Belgium, Canada, Brazil, France, Germany, the UK, Italy, Poland, Romania, Spain, the USARCTKidney transplant recipients aged 17–77 yearsProphylaxisValganciclovirValganciclovir different duration and placebo320 patients100 and 200 days12 monthsLow risk
Halim et al, 2016 31
Ghei th et al, 2017 32
Kuwait, EgyptRCTKidney transplant recipients with mean age of 42.4 yearsProphylaxisValganciclovirValganciclovir different duration201 patients98.1 days (mean)12 monthsSome concerns
Witzke et al, 201233, 201834 Germany, AustriaRCTKidney transplant recipients with mean age of 52.7 yearsProphylaxis and pre-emptive therapyValganciclovirValganciclovir as pre-emptive treatment296 patients100 days (14 days pre-emptive until 100 days)7 yearsSome concerns
Reischig et al, 2012 35 Czeck RepublicRCTKidney transplant recipients with mean age of 49 yearsProphylaxis and pre-emptive therapyValganciclovirValacyclovir70 patients3 months2 yearsSome concerns
Reischig et al, 201536 Czeck RepublicRCTKidney transplant recipients with mean age of 49 yearsProphylaxisValganciclovirValacyclovir119 patients3 months1 yearSome concerns
Togashi et al, 2011 38 JapanRCTLiver transplant recipients with mean age of 52.1 yearsPre-emptive therapyValganciclovirGanciclovir22 patients2 weeks1 yearSome concerns
Padulles et al, 2016 25 SpainRCTKidney, liver and heart transplant recipients with mean age of 53.9 yearsProphylaxis and treatmentValganciclovir/
ganciclovir
Valganciclovir/ganciclovir different dosing53 patientsNA (not reported)6 monthsLow risk
Palmer et al, 2010,
Finlen Copeland et al, 2011 26 27
USARCTLung transplant recipients with median age of 55.5 yearsProphylaxisValganciclovirPlacebo136 patients12 months3.9 years (mean)Some concerns
Chawla et al, 201128 USARCTAllogeneic transplant recipients aged 18–64Pre-emptive therapyValganciclovirGanciclovir37 patients28 days4 weeksHigh risk
Boeckh et al, 2015 29 USARCTAllogeneic transplant recipients aged 16–70Pre-emptive therapyValganciclovirPlacebo184 patients150/120 days valganciclovir/ placebo(medians)640 daysSome concerns
Kim et al, 2010 30 South KoreaRCTAllogeneic transplant recipients aged 16–49Pre-emptive therapyGanciclovirGanciclovir different dosing68 patients14 days (median)42 months (median)Some concerns
Montejo et al, 2010 39 SpainSingle-armKidney transplant recipients with median age 47 yearsProphylaxisValganciclovirNA34 patients3 months1 yearCritical risk
Nanmoku et al, 2018 40 JapanSingle-armKidney transplant recipients with mean age 48.7 yearsProphylaxisValganciclovirNA100 patients6 months1 yearSerious risk
Perrottet et al, 2009
Manuel et al, 2010 9 41
FranceSingle-armKidney, heart, lung, liver transplant recipients aged 18–70ProphylaxisValganciclovir and
ganciclovir
NA65 patients3 months1 yearSerious risk
McGillicuddy et al, 2010 USASingle-armKidney and pancreas transplant recipients mean age 53.5 yearsPre-emptive therapy and prophylaxisValganciclovir/ ganciclovirValganciclovir/
ganciclovir pre-emptive therapy
130 patients90 days1 yearSerious risk
Takenaka et al, 2012 45 JapanSingle-armAllogeneic transplant recipients aged 25–68Pre-emptive therapyValganciclovirNA20 patients2 weeks10 weeksSerious risk
Park et al, 2012 46 South KoreaSingle-armAllogeneic transplant recipients aged 16–70Pre-emptive therapyGanciclovirGanciclovir different dosing97 patients14 days (median)Not same for all patientsModerate risk
INVASIVE FUNGAL INFECTION PROPHYLAXIS
Perrella et al, 2012 47 ItalyRCTLiver transplant recipients (age NI)ProphylaxisFluconazoleAmphotericin B43 patients7–14 days1 yearSome concerns
Winston et al, 2014 17 USARCTLiver transplant recipients aged 19–75 yearsProphylaxisFluconazoleAnidulafungin200 patients21 days (median)90 daysLow risk
Chaftari et al, 2012 48 USARCTAllogeneic transplant recipients aged 20–69ProphylaxisPosaconazoleAmphothericin B lipid complex40 patients6 weeks2 weeksSome concerns
Huang et al, 2012 19 ChinaRCTAllogeneic and autologous transplant recipients with mean age 32.7 yearsProphylaxisItraconazoleMicafungin228 patients42 days4 weeksSome concerns
Park et al, 2016 49 South KoreaRCTAllogeneic and autologous transplant recipients aged 20–64ProphylaxisFluconazoleMicafungin250 patients21 days100 daysSome concerns
Mitsani et al, 2012 43 USASingle-armLung transplant recipients aged 20–74 yearsProphylaxisVoriconazoleNA93 patients3 monthsNIModerate risk
Cordonnier et al, 2010 44 France, Spain, Belgium, UK, Germany, Switzerland, Portugal, SwedenSingle-armAllogeneic transplant recipients aged 22–72 yearsProphylaxisVoriconazoleNA45 patients94 days (median)1 yearCritical risk
  • Summary assessment of risk of bias grades for:

  • RCTs using RoB tool:

  • Low risk of bias: The study is judged to be at low risk of bias for all domains for this result.

  • Some concerns: The study is judged to raise some concerns in at least one domain for this result, but not to be at high risk of bias for any domain.

  • High risk of bias: The study is judged to be at high risk of bias in at least one domain for this result.

  • Single-arm prospective studies using ROBINS tool:.

  • Low risk of bias: The study is judged to be at low risk of bias for all domains.

  • Moderate risk of bias: The study is judged to be at low or moderate risk of bias for all domains.

  • Serious risk of bias: The study is judged to be at serious risk of bias in at least one domain, but not at critical risk of bias in any domain.

  • Critical risk of bias: The study is judged to be at critical risk of bias in at least one domain.

  • NA, not applicable; NI, no information; RCT, randomised controlled trial.