Low-dose valganciclovir prophylaxis for cytomegalovirus in intermediate-risk (R+) renal transplant recipients: Single-center experience

Transpl Infect Dis. 2017 Dec;19(6). doi: 10.1111/tid.12780. Epub 2017 Nov 3.

Abstract

Renal transplant recipients (RTR) who are seropositive for CMV (R+) are considered to be at intermediate risk for CMV disease. Current guidelines recommend high-dose valganciclovir (VGCV) prophylaxis because of limited data on the efficacy of low-dose VGCV. We describe our experience with using low-dose VGCV in R+ RTR. We retrospectively reviewed a cohort of 316 R+ RTR at our institution between 2002 and 2006. The primary endpoint was CMV disease at 1 year post transplant. The incidence of CMV disease at 12 months after transplantation was only 3% (6/221) in the D+R+ and 4% (4/95) in the D-R+ RTR. Low-dose VGCV was effective at preventing CMV disease in intermediate-risk (R+) RTR.

Keywords: CMV prophylaxis; low-dose valganciclovir recipient positive; renal transplant recipients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibiotic Prophylaxis / methods*
  • Antibiotic Prophylaxis / standards
  • Antiviral Agents / administration & dosage*
  • Cytomegalovirus / isolation & purification
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / prevention & control*
  • Cytomegalovirus Infections / virology
  • Female
  • Ganciclovir / administration & dosage
  • Ganciclovir / analogs & derivatives*
  • Graft Rejection / epidemiology
  • Graft Rejection / prevention & control
  • Graft Rejection / virology
  • Humans
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Serologic Tests
  • Transplant Recipients
  • Valganciclovir
  • Young Adult

Substances

  • Antiviral Agents
  • Valganciclovir
  • Ganciclovir