title: Efficacy of ganciclovir in liver and kidney transplant recipients with severe cytomegalovirus infection.
abstract: Twelve liver and 5 kidney transplant recipients with severe cytomegalovirus infection were treated with Ganciclovir (7.5 mg/kg/day, intravenously). Ten were evaluable (compatible clinical picture, organ involvement shown histopathologically or by culture, viremia, and absence of concomitant infection). All 17 patients were studied for adverse drug side effects. A total of 9 evaluable patients survived the infection; 1 died during treatment due to infection or drug toxicity. A death 19 days after completion of treatment was due to unrelated causes. Patients became afebrile after 2-9 days (mean, 5.3 days) of treatment. Liver function improved, pulmonary infiltrates cleared, and hypoxemia reversed during therapy. Viremia ceased during therapy in 9 patients; asymptomatic viruria persisted or recurred in 6 of 7 patients studied. No relapses occurred during follow-up (7-17 months; mean, 13 months). Transient neutropenia and thrombocytopenia occurred in 3 and 1 patients, respectively. Ganciclovir appears promising for treatment of severe CMV infection in patients with kidney or liver transplants.
authors.affiliation: Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: C V
authors.initials: CV
authors.lastname: Paya
authors.forename: P E
authors.initials: PE
authors.lastname: Hermans
authors.forename: T F
authors.initials: TF
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Rakela
authors.forename: R H
authors.initials: RH
authors.lastname: Wiesner
authors.forename: R A
authors.initials: RA
authors.lastname: Krom
authors.forename: V E
authors.initials: VE
authors.lastname: Torres
authors.forename: S
authors.initials: S
authors.lastname: Sterioff
authors.forename: C J
authors.initials: CJ
authors.lastname: Wilkowske
mesh_terms: D000212:Acyclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000382:microbiology; D015774:Ganciclovir; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation; D009894:Opportunistic Infections / Q000188:drug therapy; D011014:Pneumonia / Q000150:complications; D013997:Time Factors
chemical_list: D015774:Ganciclovir; D000212:Acyclovir