Prophylaxis of CMV disease by ganciclovir (DHPG) in seronegative recipients of renal allograft from seropositive donors
In an open-label randomized study of prophylactic treatment by ganciclovir, 23 seronegative recipients of kidney allograft from seropositive donors were randomized to receive from day 14 to day 28 after transplantation either no treatment (n = 11) or ganciclovir, 5 mg/kg twice daily (n = 12). Both groups were similar in age, immunosuppressive therapy, number of acute rejections and in steroid bolus. Seroconversion occurred in ten patients of the control group (91%) and in ten of the ganciclovir group (84%). CMV disease occurred in ten patients of the control group (91%) and in eight patients of the ganciclovir group (66%), three of whom had asymptomatic viraemia. The delay between transplantation and onset of CMV disease was significantly increased by ganciclovir prophylaxis (78.5 ± 7.7 vs 46.5 ±7.5 days, P < 0.05). We conclude that in renal transplant recipients at risk of CMV disease, ganciclovir prophylaxis delays the onset of the disease and seems to decrease its incidence and its severity.
Key wordsCytomegalovirus Ganciclovir Prophylaxis Renal Transplantation
- 6.Snydman DR, Werner BG, Heinze-Lacey B, Berardi VP, Tilney NL, Kirkman RL, Milford EL, Cho SI, Bush HL, Levey AS, Strom TB, Carpenter CB, Levey RH, Harmon WE, Zimmerman CE, Shapiro ME, Steinman T, Logerfo F, Idelson B, Schroter GPJ, Levin MJ, Mclver J, Leszczynski J, Grady GF (1987) Use of cytomegalovirus immune globulin to prevent cytomegalovirus disease in renal-transplant recipients. N Engl J Med 317:1049–1054PubMedCrossRefGoogle Scholar
- 7.Tyms AS, Davis JM, Jeffries D J, Meyers JD (1984) BWB759U, an analogue of acyclovir, inhibits human cytomegalovirus in vitro. Lancet ii: 924–925Google Scholar
- 9.Weir MR, Henry ML, Blackmore M, Smith J, First MR, Irwin B, Shen S, Genemans G, Alexander JW, Corry RJ (1988) Incidence and morbidity of cytomegalovirus disease associated with a seronegative recipient receiving seropositive donor-specific transfusion and living-related donor transplantation. Transplantation 45: 111–116PubMedCrossRefGoogle Scholar