title: Valganciclovir is an effective prophylaxis for cytomegalovirus disease in liver transplant recipients.
abstract: OBJECTIVE
  Cytomegalovirus (CMV) infection is responsible for significant morbidity and mortality among solid organ transplant recipients. Prophylaxis using valganciclovir (VGCV) in orthotopic liver transplant (OLT) recipients is not approved by the Food and Drug Administration and its use is controversial. This study aimed to evaluate the effectiveness of VGCV in CMV prophylaxis in OLT recipients.
  
  
  METHODS
  We carried out a retrospective, single-centre study including all OLT procedures performed during 2005-2008. Patients with early death (at ≤ 30 days), without CMV serology or prophylaxis, or with follow-up of <1 year were excluded.
  
  
  RESULTS
  The overall incidence of CMV disease was 6% (n= 9). The ganciclovir (GCV) and VGCV groups had similar incidences of CMV disease (4.6% vs. 7.0%; P= 0.4) and similar distributions of disease presentation (CMV syndrome vs. tissue-invasive CMV; P= 0.4). Incidences of CMV infection, as well as disease presentation, were similar between the high-risk (CMV D+/R-) and non-high-risk groups (P= 0.16). Although acute cellular rejection occurred more frequently in patients who developed CMV disease (P= 0.005), overall survival in these patients did not differ from that in patients who did not develop CMV infection (P= 0.5).
  
  
  CONCLUSIONS
  Valganciclovir is an effective antiviral for the prevention of CMV disease in liver transplant recipients. Our data support its use in high-risk OLT patients.
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA. sfayek@smail.umaryland.edu
authors.forename: Sameh Adel
authors.initials: SA
authors.lastname: Fayek
authors.forename: Wana
authors.initials: W
authors.lastname: Mantipisitkul
authors.forename: Flavia
authors.initials: F
authors.lastname: Rasetto
authors.forename: Raghava
authors.initials: R
authors.lastname: Munivenkatappa
authors.forename: Rolf N
authors.initials: RN
authors.lastname: Barth
authors.forename: Benjamin
authors.initials: B
authors.lastname: Philosophe
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000998:Antiviral Agents / Q000008:administration & dosage*; D015142:Baltimore; D016009:Chi-Square Distribution; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D004334:Drug Administration Schedule; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006084:Graft Rejection / Q000517:prevention & control / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000077562:Valganciclovir; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000077562:Valganciclovir; D015774:Ganciclovir