Prophylactic therapy with valganciclovir in high-risk (cytomegalovirus D+/R-) kidney transplant recipients: a single-center experience

Transplant Proc. 2010 Oct;42(8):2947-9. doi: 10.1016/j.transproceed.2010.08.017.

Abstract

Background: A prospective study was performed in kidney transplant patients at risk of developing cytomegalovirus (CMV) infection (CMV D+/R-). They were treated with valganciclovir (VGC) for 3 months as prophylactic therapy. The aim was to determine the safety and efficacy of prophylactic therapy with VGC.

Methods: Antigenemia and/or polymerase chain reaction CMV was routinely performed every 2 weeks up to month 3, monthly to month 6, and every other month until the end of the first year posttranplantation, as well as when clinically indicated.

Results: From July 2007 to April 2010, 366 renal transplantations were performed at our center, including 34 (9%) high-risk patients for CMV infection. The median age was 47 years; 19 were males and 15 females. Twelve (35%) patients developed CMV infections: 10 (34%) gastrointestinal disease and 3 viral syndromes. The timing of the clinical manifestations was 16% (3/12) between months 1 and 3, 75% (8/12) between months 4 and 6, and 8% (1/12) in month 9 posttransplantation.

Conclusion: Treatment with intravenous ganciclovir followed by oral VGC was successful in all patients. No opportunistic infections or allograft rejection were observed; only 1 patient developed thrombocytopenia as an adverse event to VGC.

MeSH terms

  • Antiviral Agents / administration & dosage*
  • Cytomegalovirus / genetics
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / prevention & control*
  • Female
  • Ganciclovir / administration & dosage
  • Ganciclovir / analogs & derivatives*
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Valganciclovir

Substances

  • Antiviral Agents
  • Valganciclovir
  • Ganciclovir