Valganciclovir as preemptive therapy for cytomegalovirus in cytomegalovirus-seronegative liver transplant recipients of cytomegalovirus-seropositive donor allografts

✍ Scribed by Nina Singh; Cheryl Wannstedt; Lois Keyes; Debra Mayher; Lisa Tickerhoof; Mohamed Akoad; Marilyn M. Wagener; Thomas V. Cacciarelli

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 82 KB
• Volume: 14
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.21362

✦ Synopsis

The efficacy of valganciclovir as preemptive therapy for the prevention of cytomegalovirus (CMV) disease and its impact on indirect sequelae of CMV were assessed in recipient-negative/donor-positive (RϪ/Dϩ) liver transplant recipients. Of 187 consecutive liver transplant recipients at our institution since July 2001, 36 (19.2%) belonged to the RϪ/Dϩ group. Surveillance tests for CMV were performed on all patients at weeks 2, 4, 6, 8, 10,12, and 16. In all, 27 patients with asymptomatic viremia received preemptive therapy with valganciclovir. At a total follow-up of 62.8 patient years (median: 19 months, range: 3 months to 5.6 years), no episodes of CMV disease were documented in these patients. The incidence of rejection, retransplantation, and bacterial or fungal infections and the probability of survival did not differ for RϪ/Dϩ patients and all non-RϪ/Dϩ patients treated preemptively with valganciclovir (P Ͼ 0.20 for all variables). Thus, preemptive therapy with valganciclovir in RϪ/Dϩ patients was not associated with CMV disease during the period of surveillance monitoring or at anytime thereafter (late-onset CMV disease). The indirect outcomes with the use of valganciclovir in RϪ/Dϩ patients were comparable to the outcomes of other subgroups of liver transplant recipients receiving preemptive therapy.