title: Outcome of low-dose ganciclovir for cytomegalovirus disease prophylaxis in renal-transplant recipients.
abstract: To assess the outcome of low-dose-ganciclovir prophylaxis (500 mg twice a day for 3 months) in renal-transplant recipients, a retrospective analysis of 185 patients transplanted between 1998 and 2001 was performed. There were 29 (15.6%) patients who belonged to the highest risk group, donor cytomegalovirus (CMV) positive, recipient negative (D + R-), and 37 (20%) patients in the lowest risk group, D-R-. Induction immunosuppression consisted of polyclonal antibody or OKT3 (n = 62, 33.5%), interleukin-2 receptor antibody (n = 61, 33%), and no induction (n = 62, 33.5%). CMV disease occurred in 13 (7%) patients. Highest incidence was in D + R- group (17.2%), with no cases in D-R- group (P = 0.03). Tissue-invasive CMV occurred in 4 of these 13 patients. In patients developing CMV disease, there was no evidence of ganciclovir resistance and no mortality over a mean follow-up of 42 months. Low-dose ganciclovir was found to be as effective in decreasing the incidence of clinical CMV disease as high-dose ganciclovir (1 gm three times a day for 3-6 months) in previous studies.
authors.affiliation: Division of Nephrology, Henry Ford Hospital, 2799 W. Grand Boulevard, CFP-5, Detroit, MI 48202, USA. Nephron9@aol.com
authors.forename: Junaid
authors.initials: J
authors.lastname: Ahmed
authors.forename: Claudia
authors.initials: C
authors.lastname: Velarde
authors.forename: Marco
authors.initials: M
authors.lastname: Ramos
authors.forename: Khaled
authors.initials: K
authors.lastname: Ismail
authors.forename: Jose
authors.initials: J
authors.lastname: Serpa
authors.forename: Mariella
authors.initials: M
authors.lastname: Ortigosa-Goggins
authors.forename: Ravi
authors.initials: R
authors.lastname: Parasuraman
authors.forename: K K
authors.initials: KK
authors.lastname: Venkat
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000517:prevention & control*; D024882:Drug Resistance, Viral; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006084:Graft Rejection; D006085:Graft Survival; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged
chemical_list: D000998:Antiviral Agents; D006684:HLA-DR Antigens; D015774:Ganciclovir