Cytomegalovirus prophylaxis with valganciclovir in kidney, pancreas-kidney, and pancreas transplantation

Gaetano Ciancio*, George W. Burke, Adela Mattiazi, Zvi Leibovici, Lorraine Dowdy, David Roth, Warren Kupin, Anne Rosen, Delvis Jorge, Robert E. Cirocco, Joshua Miller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Cytomegalovirus, seen in more than 50% of solid organ transplant recipients, is responsible for numerous direct and indirect consequences, including infection with opportunistic pathogens and allograft rejection. Prophylaxis with intravenous ganciclovir has been the gold standard for prevention; however, intravenous treatment is expensive and carries risks of its own. Oral ganciclovir, to be effective, must be given in large, divided doses. Valganciclovir, the valine ester of ganciclovir, at 900 mg/day, provides oral bioavailability equivalent to that of intravenous ganciclovir and superior to that of oral ganciclovir. This retrospective study assessed the efficacy of 3 months prophylaxis with valganciclovir in kidney, simultaneous pancreas-kidney, and pancreas transplantation. Of 161 patients, all of whom received potent immunosuppressive regimens and were followed for a mean of 440 days, only one developed cytomegalovirus infection, at 120 days post-transplantation. Two patients died, and two others lost their grafts. There were seven incidents of acute rejection. Only seven patients discontinued treatment early, five because of leukopenia. These results suggest that prophylaxis with 900 mg/day of valganciclovir for at least 3 months safely and effectively prevents cytomegalovirus infection in kidney, simultaneous pancreas-kidney and pancreas transplant recipients on highly potent immunosuppression.

Original languageEnglish (US)
Pages (from-to)402-406
Number of pages5
JournalClinical Transplantation
Volume18
Issue number4
DOIs
StatePublished - Aug 1 2004

Keywords

  • Cytomegalovirus
  • Kidney
  • Pancreas
  • Transplantation
  • Valganciclovir

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Fingerprint Dive into the research topics of 'Cytomegalovirus prophylaxis with valganciclovir in kidney, pancreas-kidney, and pancreas transplantation'. Together they form a unique fingerprint.

Cite this