title: Intravenous immunoglobulin prophylaxis of cytomegalovirus infection in pediatric renal transplant recipients.
abstract: Cytomegalovirus (CMV), the most significant infectious cause of morbidity following renal transplantation, may be a greater problem for children than for adults due to their relative lack of experience with this virus. Therefore, we prospectively gave Gammagard as prophylaxis to CMV-negative children who received CMV-positive allografts and compared the results to our experience with similar high-risk recipients transplanted prior to our use of intravenous immunoglobulin G (IvIgG). Symptomatic CMV disease developed in 17% of the IvIgG recipients as compared with 71% of the untreated patients (p = 0.01). The CMV infections that did occur in IvIgG recipients developed significantly later than in untreated children (median time of onset after transplantation 2.60 vs. 1.35 months; p < 0.05) and generally were less severe, although 1 IvIgG recipient died despite prophylaxis. IvIgG administration did not affect the frequency of rejection or graft or patient survival. We conclude that IvIgG administration to high-risk pediatric renal transplant recipients may protect against posttransplantation CMV disease and may lessen the severity of infections that do develop in patients who receive it.
authors.affiliation: Department of Pediatrics, St. Christopher's Hospital for Children, Temple University of School of Medicine, Philadelphia, Pa., USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Flynn
authors.forename: B A
authors.initials: BA
authors.lastname: Kaiser
authors.forename: S S
authors.initials: SS
authors.lastname: Long
authors.forename: S L
authors.initials: SL
authors.lastname: Schulman
authors.forename: A
authors.initials: A
authors.lastname: Deforest
authors.forename: M S
authors.initials: MS
authors.lastname: Polinsky
authors.forename: H J
authors.initials: HJ
authors.lastname: Baluarte
mesh_terms: D002648:Child; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D016756:Immunoglobulins, Intravenous