Efficacy of ganciclovir in liver and kidney transplant recipients with severe cytomegalovirus infection.
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.
Paya
C V
CV
Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Hermans
P E
PE
Smith
T F
TF
Rakela
J
J
Wiesner
R H
RH
Krom
R A
RA
Torres
V E
VE
Sterioff
S
S
Wilkowske
C J
CJ
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
D015774:Ganciclovir; D000212:Acyclovir