Comparing cytomegalovirus prophylaxis in renal transplantation: Single center experience

Marina Varga, Á Remport, M. Hídvégi, A. Péter, L. Kóbori, G. Telkes, J. Fazakas, Z. Gerlei, E. Sárváry, B. Sulyok, J. Járay

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Background: Cytomegalovirus (CMV) presents a serious threat to CMV-seronegative recipients (R -), who have received an organ from a seropositive donor (D +). Objectives: We compared the effectiveness of three different prophylactic protocols in CMV D +/R - patients and reviewed data on patients who received no prophylaxis. Patients and methods: We reviewed 1137 kidney transplantations from 1995 to 2004. Of these, 147 recipients were CMV negative (D +/R -); 125 patients received CMV prophylaxis. Group I received CMV hyperimmune gammaglobulin only, group II received CMV hyperimmune gammaglobulin plus oral ganciclovir, and group III received prophylaxis with oral ganciclovir only. Results: In group I, CMV infection was observed in 31 of 53 patients (59%), and CMV disease was diagnosed in 9 (17%) during the prophylaxis. In the first year post transplant, a total of 41 of 53 patients (77.5%) had primary CMV infection. In group II, CMV infection occurred in 7 of 30 patients (23%), and CMV disease was diagnosed in only 2 (7%) during prophylaxis. In the first year post transplant, a total of 9 of 30 patients (30%) had primary CMV infection. In group III, 9 of 42 patients (21%) developed CMV infection during prophylaxis, and CMV disease was not observed. In the first year post transplant, a total of 13 of 42 patients (30%) had primary CMV infection. In contrast, all 22 CMV D +/R - patients without prophylaxis developed CMV infection (100%); CMV disease was diagnosed in 10 (45%), and 1 patient died. Conclusions: Prophylaxis with hyperimmune gammaglobulin and/or oral ganciclovir significantly reduces CMV infection and disease. Prophylaxis with ganciclovir was significantly more effective than hyperimmune gammaglobulin monoprophylaxis, and more cost effective than combined prophylaxis.

Original languageEnglish
Pages (from-to)63-67
Number of pages5
JournalTransplant Infectious Disease
Volume7
Issue number2
DOIs
Publication statusPublished - Jun 1 2005

Keywords

  • Cytomegalovirus (CMV)
  • Ganciclovir
  • Hyperimmune gammaglobulin
  • Prophylaxis
  • Seronegative patients
  • Seropositive patients

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

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