Cytomegalovirus Prevention in High-risk Lung Transplant Recipients: Comparison of 3- vs 12-Month Valganciclovir Therapy

Long-term efficacy and safety of 12 months of valganciclovir prophylaxis compared with 3 months after lung transplantation: A single-center, long-term follow-up analysis from a randomized, controlled cytomegalovirus prevention trial

“…The randomized, double-blind study design served to minimize potential bias, and contrasts with previous retrospective studies of CMV prevention in lung transplantation that included sequential prophylaxis strategies among historical cohorts. 12,13 In fact, the effectiveness of randomization is illustrated in the baseline similarity of the extended vs short-course patients even within this single-center subset.…”

Ganciclovir-Resistant Cytomegalovirus Infections among Lung Transplant Recipients Are Associated with Poor Outcomes despite Treatment with Foscarnet-Containing Regimens

“…Controversy persists, however, over the recommended duration of valganciclovir prophylaxis. Several reports, including one from our program, demonstrated that courses Ն6 months are superior to shorter courses (8,14,19). More recently, a multicenter study of 136 lung transplant recipients showed that valganciclovir prophylaxis for 12 months significantly reduced active infections compared to a 3-month course (17).…”

“…Valganciclovir, an oral prodrug that achieves ganciclovir concentrations comparable to those of intravenous (i.v.) ganciclovir (11), is at least as effective and safe in reducing CMV infections after lung transplantation (8,(12)(13)(14)(15)(16)(17)(18). Controversy persists, however, over the recommended duration of valganciclovir prophylaxis.…”

Update on lung transplantation: programmes, patients and prospects

“…The current state-of-the art regarding CMV management in LTR combines a universal prophylaxis protocol for usually 3-6 months post-transplant coupled with protocols for routine diagnostic testing for CMV that can then guide pre-emptive intervention strategies, with full treatment protocols being reserved for break-through clinical disease [169,172,182,183]. Although this extended approach has had the overall benefit of reducing CMV events in LTR, late CMV can still occur [172,173,184,185] thereby raising the possibility that longterm prophylaxis may have additional benefits [183,185,186].…”