Long-term ganciclovir prophylaxis for successful prevention of primary cytomegalovirus (CMV) disease in CMV-seronegative liver transplant recipients with CMV-seropositive donors.
BACKGROUND
We conducted a trial of long-term ganciclovir prophylaxis for prevention of primary cytomegalovirus (CMV) disease in CMV-seronegative liver transplant recipients with CMV-seropositive donors.


METHODS
Patients received intravenous ganciclovir at a dose of 6 mg/kg once a day from day 1 to day 30 after transplant, and then at a dose of 6 mg/kg once a day, Monday through Friday, until day 100. Forty-seven consecutive patients were evaluated. Due to the primary physician's decision or administrative error, 10 patients received less than 7 weeks of ganciclovir (mean duration, 3 weeks).


RESULTS
Four of the 10 (40%) patients who received less than 7 weeks of ganciclovir developed CMV disease (hepatitis). In contrast, none of the 37 patients given 100 days of prophylactic ganciclovir developed CMV disease while receiving ganciclovir. Two patients (5.4%) subsequently developed CMV disease (hepatitis) 21 and 88 days, respectively, after completing their ganciclovir prophylaxis. Reversible neutropenia in three patients (8.1%) was the only side effect associated with long-term ganciclovir. Complications from central intravenous catheters did not occur.


CONCLUSIONS
These results reaffirm the efficacy and safety of long-term ganciclovir prophylaxis for prevention of primary CMV disease in a large number of high-risk CMV-seronegative liver transplant recipients with CMV-seropositive donors.
Seu
P
P
Dumont-UCLA Transplant Center, Department of Surgery, Los Angeles, California 90095, USA.
Winston
D J
DJ
Holt
C D
CD
Kaldas
F
F
Busuttil
R W
RW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000517:prevention & control* / Q000635:transmission; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008875:Middle Aged
D000914:Antibodies, Viral; D000998:Antiviral Agents; D015774:Ganciclovir