Low-Dose vs Standard-Dose Valganciclovir for Cytomegalovirus Prophylaxis After Kidney Transplantation: A Single-Center Retrospective Analysis.
Transplant Proc
; 56(1): 105-110, 2024.
Article
en En
| MEDLINE
| ID: mdl-38199858
ABSTRACT
BACKGROUND:
Prophylactic administration of valganciclovir (VG) is an accepted method for the prevention of cytomegalovirus (CMV) infection after kidney transplantation (KTx). The standard dosage of oral VG is 900 mg/day, adjusted to renal function. There is growing evidence that low-dose 450 mg/day VG might be safe and effective. We compared low-dose vs standard-dose prophylaxis after KTx in a single-center follow-up study.METHODS:
Data from 603 renal transplantations at a single center were retrospectively analyzed (2011-2014, 12-month follow-up). Recipients with donor IgG positive-recipient IgG positive (D+/R+), (D+/R-), and (D-/R+) CMV serostatus were routinely treated with 450 mg/day VG for 3 months. Based on the same prophylactic dose, patients could be categorized into two groups according to their postoperative renal function those receiving standard-dose VG due to a lower estimated glomerular filtration rate (eGFR) (average eGFR<60 mL/min/1.73 m2) and those receiving low-dose VG due to higher eGFR (average eGFR>60 mL/min/1.73 m2).RESULTS:
Estimated glomerular filtration rate-based VG serum alterations significantly affected the risk of CMV infection with a higher incidence in higher VG levels (standard-dose 357 patients, CMV 33 cases (9.2 %); low-dose 246 patients, CMV 10 cases (4.1%). The occurrence of known risk factors serologic risk distribution and rate of induction therapy were not statistically different between the 2 groups. Treatment of an acute rejection episode influenced the infection rate significantly in the standard-dose group. As a side effect of prophylaxis, leucopenia (<3G/L) was 2.46 times higher in standard-dose vs low-dose group.CONCLUSION:
Low-dose VG administration is safe and non-inferior to the standard dose in the prophylaxis of CMV infection after KTx.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Trasplante de Riñón
/
Infecciones por Citomegalovirus
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Transplant Proc
/
Transplant. proc
/
Transplantation proceedings
Año:
2024
Tipo del documento:
Article
País de afiliación:
Hungria