Cytomegalovirus prophylaxis using oral ganciclovir or valganciclovir in kidney and pancreas-kidney transplantation under antibody preconditioning

K. Keven, Amit Basu, H. P. Tan, N. Thai, A. Khan, A. Marcos, T. E. Starzl, R. Shapiro

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37 Scopus citations

Abstract

We investigated retrospectively the risk factors for cytomegalovirus (CMV) infection under gancidovir or valgancidovir prophylaxis (oral ganciclovir 1 g tid, valganciclovir 450 mg/d) in our kidney and simultaneous pancreas-kidney (SPK) transplant patients undergoing transplantation between July 1, 2001 and February 28, 2003. Two hundred eleven patients receiving prophylactic oral gancidovir or valganciclovir were included in the study. All patients were given antibody preconditioning (thymoglobulin 178, alemtuzumab 33). Duration of prophylactic treatment was between 3 and 8 months. Fifteen (7.1%) patients developed a positive CMV antigenemia in the first 6 months after transplantation, and 18 of 176 (10.2%) patients developed a positive CMV antigenemia during the first year. No patient developed tissue invasive CMV disease. At 6 months after transplantation, valganciclovir was slightly more effective than gancidovir prophylaxis (P = .052). Positive donor CMV serology significantly increased the risk of CMV infection compared to CMV-negative donors (P = .014 and P = .003 at 6 and 12 months, respectively). Duration of CMV prophylaxis for more than 3 months decreased the risk of CMV infection (P = .04 and P = .009 at 6 and 12 months, respectively). Either valganciclovir prophylaxis (450 mg/d) or high-dose oral ganciclovir (l g tid) is effective in preventing tissue-invasive CMV disease, and results in a low incidence of CMV antigenemia in patients undergoing kidney and SPK transplantation.

Original languageEnglish
Pages (from-to)3107-3112
Number of pages6
JournalTransplantation Proceedings
Volume36
Issue number10
DOIs
StatePublished - 2004
Externally publishedYes

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