| Low-dose valaciclovir and cytomegalovirus immunoglobulin to prevent cytomegalovirus disease in high-risk renal transplant recipients. | |
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MedLine Citation:
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PMID: 21175987 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Cytomegalovirus (CMV) remains an important cause of disease in renal transplant recipients. Prophylaxis is effective in reducing disease; however, the optimal regimen remains uncertain. We assessed the efficacy of low-dose valaciclovir (3 months) and intravenous CMV immunoglobulin in the prevention of CMV disease in CMV-negative recipients of kidneys from CMV-positive donors (D+/R-). METHODS: A single-centre, retrospective study examining the incidence of CMV disease and patient and graft survival in all patients transplanted between October 2000 and November 2004. RESULTS: Among 203 renal transplant recipients, 46 were D+/R- (22.7%) and received prophylaxis. Of the 203 recipients, 21 (10.3%) developed CMV disease over a four-year follow-up period. Within the D+/R- group, CMV disease occurred in 15.2% of patients at 6 months (7/46), and 21.7% at 4 years (10/46). Of the 10 D+/R- patients who developed CMV disease, six were inadvertently on a dose of valaciclovir below that dictated by protocol arising from a failure to increase dosage in parallel with improving recipient renal function. In the D+/R- recipients where the protocol was adhered to, the incidence of CMV disease was 5% (2/40) at 6 months, and 10% (4/40) at 4 years. CONCLUSION: Low-dose valaciclovir with CMV immunoglobulin was as efficacious in preventing CMV disease as other published regimens, including those with full-dose valaciclovir and valganciclovir. There was a low incidence of CMV disease beyond 6 months. Outcomes could be improved by ensuring appropriate dose adjustment following changes in renal function. |
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Authors:
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Nigel D Toussaint; Marcus B P Tan; Kathy Nicholls; Rowan G Walker; Solomon J Cohney |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Nephrology (Carlton, Vic.) Volume: 16 ISSN: 1440-1797 ISO Abbreviation: Nephrology (Carlton) Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9615568 Medline TA: Nephrology (Carlton) Country: Australia |
Other Details:
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Languages: eng Pagination: 113-7 Citation Subset: IM |
Copyright Information:
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© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology. |
Affiliation:
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Department of Nephrology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia. |
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