Retrospective review of the incidence of cytomegalovirus infection and disease after liver transplantation in pediatric patients: comparison of prophylactic oral ganciclovir and oral valganciclovir.
Retrospective review of the incidence of cytomegalovirus infection and disease after liver transplantation in pediatric patients: comparison of prophylactic oral ganciclovir and oral valganciclovir.
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DOI：
10.1002/lt.22471
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发表时间：
2012-03
影响因子：
4.6
通讯作者：
Kohli, Rohit
中科院分区：
文献类型：
--
作者：
Bedel, Ashley N.;Hemmelgarn, Trina S.;Kohli, Rohit
Cytomegalovirus (CMV) is the commonest viral infection after solid organ transplantation (SOT). Safe and effective prophylactic regimens that decrease incidence post-SOT are essential for long term graft survival. Although valganciclovir is not FDA approved for CMV prophylaxis in liver transplant recipients, post-marketing studies have shown valganciclovir to be as effective as ganciclovir in high risk adult SOT. Currently such data is lacking in pediatric liver transplantation. The purpose of this study was to compare the efficacy and safety of valganciclovir and ganciclovir for CMV infection prophylaxis in pediatric liver transplant recipients. This was a retrospective study of 56 pediatric liver transplant recipients prescribed either oral ganciclovir (n=37) or valganciclovir (n=19). Patients were followed until 200 days post-transplant or death. Primary outcome measure compared incidence of early onset CMV infection and CMV disease between the two medication groups. Secondary outcome measure identified patient specific factors that contributed to CMV acquisition as well as the incidence of late onset CMV infection or disease. Rate of adverse drug effects and discontinuation were also evaluated. Early onset CMV disease was documented in 0% vs. 5.4% of valganciclovir and ganciclovir patients respectively (p=0.54). There were no statistically significant differences in secondary outcomes. A trend for increased incidence of late onset CMV disease was seen in the valganciclovir group (22.2 vs. 8.1%; p=0.23). No differences in adverse events were reported. Conclusion: No statistically significant difference was found when comparing the incidence of CMV infection and disease between oral valganciclovir and ganciclovir.
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