Oral ganciclovir versus valganciclovir for cytomegalovirus prophylaxis in high-risk liver transplant recipients

R. L. Brady, K. Green, Chris Frei, Pamela Maxwell

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

This retrospective review compared oral valganciclovir (VGCV) 450 mg daily for 6 months versus oral ganciclovir (GCV) 1000 mg 3 times daily for 3 months in preventing cytomegalovirus (CMV) disease in high-risk liver transplant recipients. We evaluated all CMV donor positive-recipient negative liver transplant recipients managed at University Health System in San Antonio, Texas from August 1996 to September 2006. CMV disease was confirmed by polymerase chain-reaction or antigenemia assay, and CMV invasive disease by tissue biopsy. Patient demographics, laboratory results, complications, and therapies were collected via retrospective chart review. Patients <18 years of age or those who died during transplant admission were excluded. Primary endpoints included incidence, onset, and severity of CMV disease up to 1 year post transplant. Data collection also included patient demographics, immunosuppression, CMV treatment regimens, and relevant lab results. A total of 64 patients (43 VGCV and 21 GCV) were identified. Four patients developed CMV disease: VGCV (3/43, 7%) versus GCV (1/21, 5%) (P=1.0), with 1 VGCV patient experiencing tissue-invasive CMV. In all cases, onset of CMV disease occurred after prophylaxis was discontinued. Onset occurred at 24, 27, and 45 weeks post transplant in the VGCV group, and at 26 weeks in the 1 patient on GCV. Four patients received rabbit anti-thymocyte globulin (rATG) induction; 1 patient received rATG and developed CMV disease, with no statistical difference compared with the 3 remaining patients who received rATG but did not develop CMV disease (P=0.09). No difference was found in incidence of CMV disease between patients who received GCV and those who received VGCV at our institution.

Original languageEnglish (US)
Pages (from-to)106-111
Number of pages6
JournalTransplant Infectious Disease
Volume11
Issue number2
DOIs
StatePublished - Apr 2009

Fingerprint

Ganciclovir
Cytomegalovirus
Liver
Antilymphocyte Serum
Rabbits
Transplants
Transplant Recipients
valganciclovir
Demography
Incidence
Immunosuppression

Keywords

  • Cytomegalovirus
  • Ganciclovir
  • Liver transplant
  • Prophylaxis
  • Valganciclovir

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

Oral ganciclovir versus valganciclovir for cytomegalovirus prophylaxis in high-risk liver transplant recipients. / Brady, R. L.; Green, K.; Frei, Chris; Maxwell, Pamela.

In: Transplant Infectious Disease, Vol. 11, No. 2, 04.2009, p. 106-111.

Research output: Contribution to journalArticle

Brady, R. L. ; Green, K. ; Frei, Chris ; Maxwell, Pamela. / Oral ganciclovir versus valganciclovir for cytomegalovirus prophylaxis in high-risk liver transplant recipients. In: Transplant Infectious Disease. 2009 ; Vol. 11, No. 2. pp. 106-111.
@article{443fea8f5c2c4197b106c85540c62f23,
title = "Oral ganciclovir versus valganciclovir for cytomegalovirus prophylaxis in high-risk liver transplant recipients",
abstract = "This retrospective review compared oral valganciclovir (VGCV) 450 mg daily for 6 months versus oral ganciclovir (GCV) 1000 mg 3 times daily for 3 months in preventing cytomegalovirus (CMV) disease in high-risk liver transplant recipients. We evaluated all CMV donor positive-recipient negative liver transplant recipients managed at University Health System in San Antonio, Texas from August 1996 to September 2006. CMV disease was confirmed by polymerase chain-reaction or antigenemia assay, and CMV invasive disease by tissue biopsy. Patient demographics, laboratory results, complications, and therapies were collected via retrospective chart review. Patients <18 years of age or those who died during transplant admission were excluded. Primary endpoints included incidence, onset, and severity of CMV disease up to 1 year post transplant. Data collection also included patient demographics, immunosuppression, CMV treatment regimens, and relevant lab results. A total of 64 patients (43 VGCV and 21 GCV) were identified. Four patients developed CMV disease: VGCV (3/43, 7{\%}) versus GCV (1/21, 5{\%}) (P=1.0), with 1 VGCV patient experiencing tissue-invasive CMV. In all cases, onset of CMV disease occurred after prophylaxis was discontinued. Onset occurred at 24, 27, and 45 weeks post transplant in the VGCV group, and at 26 weeks in the 1 patient on GCV. Four patients received rabbit anti-thymocyte globulin (rATG) induction; 1 patient received rATG and developed CMV disease, with no statistical difference compared with the 3 remaining patients who received rATG but did not develop CMV disease (P=0.09). No difference was found in incidence of CMV disease between patients who received GCV and those who received VGCV at our institution.",
keywords = "Cytomegalovirus, Ganciclovir, Liver transplant, Prophylaxis, Valganciclovir",
author = "Brady, {R. L.} and K. Green and Chris Frei and Pamela Maxwell",
year = "2009",
month = "4",
doi = "10.1111/j.1399-3062.2008.00356.x",
language = "English (US)",
volume = "11",
pages = "106--111",
journal = "Transplant Infectious Disease",
issn = "1398-2273",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Oral ganciclovir versus valganciclovir for cytomegalovirus prophylaxis in high-risk liver transplant recipients

AU - Brady, R. L.

AU - Green, K.

AU - Frei, Chris

AU - Maxwell, Pamela

PY - 2009/4

Y1 - 2009/4

N2 - This retrospective review compared oral valganciclovir (VGCV) 450 mg daily for 6 months versus oral ganciclovir (GCV) 1000 mg 3 times daily for 3 months in preventing cytomegalovirus (CMV) disease in high-risk liver transplant recipients. We evaluated all CMV donor positive-recipient negative liver transplant recipients managed at University Health System in San Antonio, Texas from August 1996 to September 2006. CMV disease was confirmed by polymerase chain-reaction or antigenemia assay, and CMV invasive disease by tissue biopsy. Patient demographics, laboratory results, complications, and therapies were collected via retrospective chart review. Patients <18 years of age or those who died during transplant admission were excluded. Primary endpoints included incidence, onset, and severity of CMV disease up to 1 year post transplant. Data collection also included patient demographics, immunosuppression, CMV treatment regimens, and relevant lab results. A total of 64 patients (43 VGCV and 21 GCV) were identified. Four patients developed CMV disease: VGCV (3/43, 7%) versus GCV (1/21, 5%) (P=1.0), with 1 VGCV patient experiencing tissue-invasive CMV. In all cases, onset of CMV disease occurred after prophylaxis was discontinued. Onset occurred at 24, 27, and 45 weeks post transplant in the VGCV group, and at 26 weeks in the 1 patient on GCV. Four patients received rabbit anti-thymocyte globulin (rATG) induction; 1 patient received rATG and developed CMV disease, with no statistical difference compared with the 3 remaining patients who received rATG but did not develop CMV disease (P=0.09). No difference was found in incidence of CMV disease between patients who received GCV and those who received VGCV at our institution.

AB - This retrospective review compared oral valganciclovir (VGCV) 450 mg daily for 6 months versus oral ganciclovir (GCV) 1000 mg 3 times daily for 3 months in preventing cytomegalovirus (CMV) disease in high-risk liver transplant recipients. We evaluated all CMV donor positive-recipient negative liver transplant recipients managed at University Health System in San Antonio, Texas from August 1996 to September 2006. CMV disease was confirmed by polymerase chain-reaction or antigenemia assay, and CMV invasive disease by tissue biopsy. Patient demographics, laboratory results, complications, and therapies were collected via retrospective chart review. Patients <18 years of age or those who died during transplant admission were excluded. Primary endpoints included incidence, onset, and severity of CMV disease up to 1 year post transplant. Data collection also included patient demographics, immunosuppression, CMV treatment regimens, and relevant lab results. A total of 64 patients (43 VGCV and 21 GCV) were identified. Four patients developed CMV disease: VGCV (3/43, 7%) versus GCV (1/21, 5%) (P=1.0), with 1 VGCV patient experiencing tissue-invasive CMV. In all cases, onset of CMV disease occurred after prophylaxis was discontinued. Onset occurred at 24, 27, and 45 weeks post transplant in the VGCV group, and at 26 weeks in the 1 patient on GCV. Four patients received rabbit anti-thymocyte globulin (rATG) induction; 1 patient received rATG and developed CMV disease, with no statistical difference compared with the 3 remaining patients who received rATG but did not develop CMV disease (P=0.09). No difference was found in incidence of CMV disease between patients who received GCV and those who received VGCV at our institution.

KW - Cytomegalovirus

KW - Ganciclovir

KW - Liver transplant

KW - Prophylaxis

KW - Valganciclovir

UR - http://www.scopus.com/inward/record.url?scp=64249105728&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=64249105728&partnerID=8YFLogxK

U2 - 10.1111/j.1399-3062.2008.00356.x

DO - 10.1111/j.1399-3062.2008.00356.x

M3 - Article

C2 - 19054381

AN - SCOPUS:64249105728

VL - 11

SP - 106

EP - 111

JO - Transplant Infectious Disease

JF - Transplant Infectious Disease

SN - 1398-2273

IS - 2

ER -