Prophylaxis for cytomegalovirus with low-dose valganciclovir after renal transplantation
10.3760/cma.j.cn421203-20191022-00383
- VernacularTitle:低剂量缬更昔洛韦预防肾移植术后巨细胞病毒感染的疗效观察
- Author:
Fan LIU
1
;
Yang LI
;
Chenguang DING
;
Xinshun FENG
;
Jun HOU
;
Hang YAN
;
Jin ZHENG
;
Wujun XUE
;
Xiaoming DING
Author Information
1. 西安交通大学第一附属医院肾移植科 710061
- From:
Chinese Journal of Organ Transplantation
2020;41(4):227-231
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of low-dose valganciclovir for preventing CMV infection after renal transplantation.Methods:Patients undergoing the first renal transplantation from January 2015 to January 2017 were selected. Recipients were divided into two groups according to anti-CMV prophylactic strategy. Recipients in test group (valganciclovir group, n=85) received oral valganciclovir 450 mg once daily and those in control group (ganciclovir group, n=81) had oral ganciclovir 1g thrice daily. Both drugs were prescribed within 10 days after transplantation and maintained for 3 months. Dose adjustments were based upon renal function. All recipients were followed up for 12 months posttransplantation. CMV-DNA, renal function, blood routine and liver function were regularly monitored. The incidence of CMV infection/disease, the median time to CMV infection onset, the incidence of opportunistic infections (OI) and acute rejection, graft or recipient survival and drug safety were evaluated.Results:A total of 166 renal recipients were admitted. Fewer recipients in test group (12, 14.1 %) than in control group (26, 32.1 %) had CMV infection ( P=0.006). The median time to CMV infection onset was longer in test group than in control group: 140.5 days (interquartile range [IQR]: 77.3-198.5 days) versus 47.5 days (IQR: 36.8-67.8 days) respectively ( P=0.014). The CMV disease rate was lower in test group ( P=0.080). The incidence of OI decreased significantly in test group (10.6 % vs 21.0 %, P=0.037). No patients in test group suffered allograft loss while 6 recipients (7.4 %) in control group ( P=0.032). Other adverse and side effects of both regimens were comparable. Conclusions:Low-dose valganciclovir regimen is both safe and efficacious in preventing CMV infection among kidney transplant recipients during the first year posttransplantation.
