Prophylactic Oral Ganciclovir Compared With Deferred Therapy for Control of Cytomegalovirus in Renal Transplant Recipients1,2,???

Brennan, Daniel C.; Garlock, Kathy A.; Singer, Gary G.; Schnitzler, Mark A.; Lippmann, Bruce J.; Buller, Richard S.; Gaudreault‐Keener, Monique; Lowell, Jeffrey A.; Shenoy, Surendra; Howard, Todd K.; Storch, Gregory A.

doi:10.1097/00007890-199712270-00036

Cited by 141 publications

(82 citation statements)

References 9 publications

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“…Prospective monitoring after prophylaxis was not used and CMV disease occurred in less than 20% of the D+/R− patients. This is similar to results from this study and a previous study (25).…”

Section: Oral Valganciclovir In Kidney Transplantationsupporting

confidence: 93%

Prophylactic Versus Preemptive Oral Valganciclovir for the Management of Cytomegalovirus Infection in Adult Renal Transplant Recipients

Khoury

Storch

Bohl

et al. 2006

American Journal of Transplantation

299

292

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Prophylaxis reduces cytomegalovirus (CMV) disease, but is associated with increased costs and risks for side effects, viral resistance and late onset CMV disease. Preemptive therapy avoids drug costs but requires frequent monitoring and may not prevent complications of asymptomatic CMV replication. Kidney transplant recipients at risk for CMV (D+/R−, D+/R+, D−/R+) were randomized to prophylaxis (valganciclovir 900 mg q.d. for 100 days, n = 49) or preemptive therapy (900 mg b.i.d. for 21 days, n = 49) for CMV DNAemia (CMV DNA level >2000 copies/mL in ≥ 1 whole blood specimens by quantitative PCR) assessed weekly for 16 weeks and at 5, 6, 9 and 12 months. More patients in the preemptive group, 29 (59%) than in the prophylaxis group, 14 (29%) developed CMV DNAemia, p = 0.004. Late onset of CMV DNAemia (>100 days after transplant) occurred in 11 (24%) randomized to prophylaxis, and none randomized to preemptive therapy. Symptomatic infection occurred in five patients, four (3 D+/R− and 1 D+/R+) in the prophylactic group and one (D+/R−) in the preemptive group. Peak CMV levels were highest in the D+/R− patients. Both strategies were effective in preventing symptomatic CMV. Overall costs were similar and insensitive to wide fluctuations in costs of either monitoring or drug.

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Section: Oral Valganciclovir In Kidney Transplantationsupporting

confidence: 93%

Prophylactic Versus Preemptive Oral Valganciclovir for the Management of Cytomegalovirus Infection in Adult Renal Transplant Recipients

Khoury

Storch

Bohl

et al. 2006

American Journal of Transplantation

299

292

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“…Among renal allograft recipients who receive antithymocyte induction therapy, PCR of buffy coat specimen is superior to conventional culture monitoring for the detection of CMV viremia (51,120). Based on a positive CMV PCR, preemptive therapy with ganciclovir decreased symptomatic CMV episodes, although the overall cost was equivalent between those who received preemptive therapy and those in whom treatment was deferred (51).…”

Section: Preemptive Prophylaxismentioning

confidence: 99%

“…Based on a positive CMV PCR, preemptive therapy with ganciclovir decreased symptomatic CMV episodes, although the overall cost was equivalent between those who received preemptive therapy and those in whom treatment was deferred (51).…”

Section: Preemptive Prophylaxismentioning

confidence: 99%

New Strategies for Prevention and Therapy of Cytomegalovirus Infection and Disease in Solid-Organ Transplant Recipients

Sia¹,

Patel²

2000

Clinical Microbiology Reviews

220

181

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“…Finally, relationships between CMV sero-pairing and graft and patient survival and the relative incidence of CMV disease may have changed since earlier reports (14±16,20). This study was designed to address these issues using a national cohort of cadaveric renal transplant recipients drawn from the United States Renal Data System (USRDS) transplanted between 1995 and 1997, prior to the widespread adoption of ganciclovir prophylaxis for CMV disease in renal transplantation (21). This study provides baseline information from a large national cohort for further investigations of prophylaxis and management strategies for CMV in renal transplantation.…”

Section: Introductionmentioning

confidence: 99%

The Association of Cytomegalovirus Sero-Pairing with Outcomes and Costs Following Cadaveric Renal Transplantation Prior to the Introduction of Oral Ganciclovir CMV Prophylaxis

Schnitzler

Lowell

Hardinger

et al. 2003

American Journal of Transplantation

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Prophylactic Oral Ganciclovir Compared With Deferred Therapy for Control of Cytomegalovirus in Renal Transplant Recipients1,2,???

Abstract: An initial 12-week course of oral ganciclovir prevents CMV disease and infection in renal transplant recipients during prophylaxis, and the benefits persist after discontinuation.

Cited by 141 publications

References 9 publications

Prophylactic Versus Preemptive Oral Valganciclovir for the Management of Cytomegalovirus Infection in Adult Renal Transplant Recipients

Prophylactic Versus Preemptive Oral Valganciclovir for the Management of Cytomegalovirus Infection in Adult Renal Transplant Recipients

New Strategies for Prevention and Therapy of Cytomegalovirus Infection and Disease in Solid-Organ Transplant Recipients

The Association of Cytomegalovirus Sero-Pairing with Outcomes and Costs Following Cadaveric Renal Transplantation Prior to the Introduction of Oral Ganciclovir CMV Prophylaxis

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