[Value of a short (7 days) prophylactic course of ganciclovir in the prevention of cytomegalovirus disease after heart transplantation].
BACKGROUND
The incidence of cytomegalovirus disease remains important after heart transplantation, mainly in the first months after transplantation. We undertook a study to evaluate a short (7 days) prophylactic administration of ganciclovir to prevent cytomegalovirus disease after heart transplantation.


METHODS
There were two groups of patients: patients transplanted in 1993 (37) and patients transplanted in 1992 (38). In the first group, ganciclovir was given intravenously at a dose of 10 mg per kilogram of body weight every day from postoperative day 1 through day 7. In the second group, ganciclovir was not given. Similar regimens of immunosuppression (ATG, deflazacort, azathioprine and cyclosporine) were given.


RESULTS
Age, sex, serology in recipients and donors and incidence of acute rejection were comparable between both groups. Mortality was slightly higher in ganciclovir group (35%) than in control group (26%), although this difference was not statistically significant. There were two cases of cytomegalovirus disease in the ganciclovir group (6%) and nine cases in the control group (27%) (p < 0.05), all of them treated successfully. Cytomegalovirus disease in ganciclovir group occurred in two children, who were seronegative before transplantation. The incidence of cytomegalovirus disease in the pediatric recipients of ganciclovir group were 50% (2 of 4) and 100% in the control group (1 of 1). The incidence of cytomegalovirus disease were therefore 0% in the adult subgroup of ganciclovir group and 24% in the adult subgroup of control group.


CONCLUSIONS
A short (7 days) prophylactic administration of ganciclovir reduces the incidence of cytomegalovirus disease. In the pediatric group, the effectiveness is lower.
Giménez
D
D
Unidad de Trasplante Cardíaco y Servicios de Medicina Interna, Córdoba.
María Arizón
J
J
de la Torre
J
J
Anguita
M
M
Escauriaza
J
J
López Granados
A
A
Mesa
D
D
Torres
F
F
Casares
J
J
Concha
M
M
Vallés
F
F
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000517:prevention & control*; D003627:Data Interpretation, Statistical; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage*; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D000998:Antiviral Agents; D015774:Ganciclovir
Valor de una pauta profiláctica corta (7 días) de ganciclovir en la prevención de la enfermedad por citomegalovirus tras el trasplante cardíaco.