E-ISSN: 2147-2688
Efficacy of Low Dose Valganciclovir Prophylaxis for Cytomegalovirus Infection in Kidney Transplantation
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Original Article
VOLUME: 58 ISSUE: 1
P: 27-32
January 2020

Efficacy of Low Dose Valganciclovir Prophylaxis for Cytomegalovirus Infection in Kidney Transplantation

Med Bull Haseki 2020;58(1):27-32
DOI: 10.4274/haseki.galenos.2019.5251
Ümit Özçelik 1
Nadir Alpay 2
Eryiğit Eren 3
Bora Uslu 4
Ahmet Cem Yardımcı 5
1. İstanbul Aydın Üniversitesi Tıp Fakültesi, Uygulama ve Araştırma Merkezi Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye
2. İstanbul Aydın Üniversitesi Tıp Fakültesi, Uygulama ve Araştırma Merkezi Hastanesi, Nefroloji Kliniği, İstanbul, Türkiye
3. İstinye Üniversitesi Tıp Fakültesi, Uygulama ve Araştırma Merkezi Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye
4. İstinye Üniversitesi Tıp Fakültesi, Uygulama ve Araştırma Merkezi Hastanesi, Nefroloji Kliniği, İstanbul, Türkiye
5. İstanbul Aydın Üniversitesi Tıp Fakültesi, Uygulama ve Araştırma Merkezi Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, İstanbul, Türkiye
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No information available
Received Date: 21.03.2019
Accepted Date: 10.08.2019
Publish Date: 18.02.2020
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ABSTRACT

Aim:

Valganciclovir is the preferred drug for chemoprophylaxis for the prevention of cytomegalovirus (CMV) infection in kidney recipients. Low-dose (450 mg/day) valganciclovir use is gaining popularity because standard dose (900 mg/day) has negative effect on renal function and side effects such as leukopenia. We present our results with low-dose valganciclovir prophylaxis in kidney recipients.

Methods:

One hundred thirteen kidney transplant recipients who were operated between 1 December 2017 and 1 September 2018 in İstanbul Aydın University Faculty of Medicine, Training and Research Hospital and İstinye University Training and Research Hospital were retrospectively evaluated. Demographic data, preoperative CMV status, incidence of CMV infection and leukopenia rates were recorded.

Results:

A total of 113 patients (46 women, 67 men) with a mean age of 42.85 years were evaluated. All the recipients and donors were preoperative CMV IgG-positive. The mean follow-up was seven (6-13) months. In this period, only two (1.76%) CMV infection occurred and treated with intravenous ganciclovir. There were no complications due to CMV infection. There was no leukopenia related with valganciclovir.

Conclusion:

This study showed that low-dose valganciclovir is an effective prophylaxis for CMV infection in kidney transplantation with CMV-positive donors and recipients. We recommend low-dose valganciclovir due to low incidence of CMV infection found in our study.

References

1Lee JH, Hwang SD, Song JH, et al. Efficacy of Ultralow-Dose Valganciclovir Chemoprophylaxis for Cytomegalovirus Infection in ABO-Incompatible Kidney Transplantation Recipients. Transplant Proc 2018;50:2485-8.
2Stevens DR, Sawinski D, Blumberg E, Galanakis N, Bloom RD, Trofe-Clark J. Increased risk of breakthrough infection among cytomegalovirus donor-positive/recipient-negative kidney transplant recipients receiving lower-dose valganciclovir prophylaxis. Transpl Infect Dis 2015;17:163-73.
3Posadas Salas MA, Taber DJ, Chua E, Pilch N, Chavin K, Thomas B. Critical analysis of valganciclovir dosing and renal function on the development of cytomegalovirus infection in kidney transplantation. Transpl Infect Dis 2013;15:551-8.
4Gabardi S, Magee CC, Baroletti SA, Powelson JA, Cina JL, Chandraker AK. Efficacy and safety of low-dose valganciclovir for prevention of cytomegalovirus disease in renal transplant recipients: a single-center, retrospective analysis. Pharmacotherapy 2004;24:1323-30.
5Avidan YP, Paul M, Rahamimov R, et al. Selective low-dose valganciclovir for prevention of cytomegalovirus disease following kidney transplantation. J Infect 2008;57:236-40.
6Parreira L, Bruges M, Gaspar A, Weigert A, Machado D. Prevention of cytomegalovçirus disease in renal transplantation: single-center experience. Transplant Proc 2009;41:877-9.
7Kalil AC, Mindru C, Florescu DF. Effectiveness of valganciclovir 900 mg versus 450 mg for cytomegalovirus prophylaxis in transplantation: direct and indirect treatment comparison meta-analysis. Clin Infect Dis 2011;52:313-21.
8Welker H, Farhan M, Humar A, Washington C. Ganciclovir pharmacokinetic parameters do not change when extending valganciclovir cytomegalovirus prophylaxis from 100 to 200 days. Transplantation 2010;90:1414-9.
9Wiltshire H, Paya C, Pescovitz M, et al. Pharmacodynamics of oral ganciclovir and valganciclovir in solid organ transplant recipients. Transplantation 2005;79:1477-83.
10Czock D, Scholle C, Rasche FM, Schaarschmidt D, Keller F. Pharmacokinetics of valganciclovir and ganciclovir in renal impairment. Clin Pharmacol Ther 2002;72:142-50.
11Wéclawiak H, Kamar N, Mengele C, et al. Cytomegalovirus prophylaxis with valganciclovir in cytomegalovirus-seropositive kidney-transplant patients. J Med Virol 2008;80:1228-32.
12Boivin G, Goyette N, Gilbert C, et al. Absence of cytomegalovirus-resistance mutations after valganciclovir prophylaxis, in a prospective multicenter study of solid-organ transplant recipients. J Infect Dis 189:1615-8.
13Akalin E, Bromberg JS, Sehgal V, Ames S, Murphy B. Decreased incidence of cytomegalovirus infection in thymoglobulin-treated transplant patients with 6 months of valganciclovir prophylaxis. Am J Transplant 2004;4:148-9.
14Bhat V, McIntyre M, Meyers T. Efficacy and safety of a lower-dose valganciclovir (valcyte) regimen for cytomegalovirus prophylaxis in kidney and pancreas transplant recipients. P T 2010;35:676-9.
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