Controlled trial of prophylactic versus therapeutic use of ganciclovir after liver transplantation in adults.
The potential of prophylactic ganciclovir for the control of cytomegalovirus (CMV) infection was evaluated in a prospective controlled trial of 65 patients after liver transplantation. A group of 33 patients received ganciclovir (10 mg/kg/day) during the third and fourth weeks after transplantation, while 32 patients were randomised to receive ganciclovir (10 mg/kg/day) only when clinical CMV disease was diagnosed. Eight patients (25%) in the latter group received ganciclovir and included the only death attributed to CMV infection in the study. Prophylactic ganciclovir was associated with a lower incidence of serologically diagnosed secondary infection and the development of the IgM anti-CMV antibody. However, the frequency of clinical infections was similar in the two groups (9/33 vs. 11/32). Liver function tests during the second month after transplantation were not significantly better in the patients receiving prophylactic ganciclovir. Leucopaenia was not seen in patients receiving prophylactic ganciclovir.
Cohen
A T
AT
Institute of Liver Studies, King's College School of Medicine and Dentistry, London, United Kingdom.
O'Grady
J G
JG
Sutherland
S
S
Sallie
R
R
Tan
K C
KC
Williams
R
R
D000328:Adult; D000914:Antibodies, Viral / Q000096:biosynthesis; D001772:Blood Cell Count / Q000187:drug effects; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007075:Immunoglobulin M / Q000096:biosynthesis; D007970:Leukopenia / Q000517:prevention & control; D008099:Liver / Q000187:drug effects; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000914:Antibodies, Viral; D006454:Hemoglobins; D007075:Immunoglobulin M; D003404:Creatinine; D015774:Ganciclovir