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.
Institute of Liver Studies, King's College School of Medicine and Dentistry, London, United Kingdom.
A T
AT
Cohen
J G
JG
O'Grady
S
S
Sutherland
R
R
Sallie
K C
KC
Tan
R
R
Williams
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