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Clinical outcome with low-dose valacyclovir in high-risk renal transplant recipients: a 10-year experience
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
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2013 (English)In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 28, no 3, 758-765 p.Article in journal (Refereed) Published
Abstract [en]

Background

Cytomegalovirus (CMV) remains an important pathogen in transplant patients, and valacyclovir (VACV) prophylaxis 8 g/day has been used in high-risk CMV-seromismatched [D+/R-] renal transplant patients to decrease CMV disease. Neurotoxic adverse effects have limited its use, and the aim of the present study was to retrospectively evaluate low-dose VACV prophylaxis, 3 g/day for 90 days after transplantation, in 102 D+/R- renal transplant patients.

Methods

We compared patient and graft survival rates up to 5 years after transplantation with the data from the Collaborative Transplant Study Group (CTS) database. The incidence of CMV disease, rejection and neurotoxic adverse effects was analyzed up to 1 year after transplantation.

Results

The patient and graft survival rates up to 5 years were comparable with those derived from the CTS. CMV disease was diagnosed in 25% of the patients and 2% developed tissue-invasive CMV disease. The rejection frequency was 22% and neurotoxic adverse effects were seen in 2% of the patients.

Conclusions

Low-dose VACV prophylaxis (3 g/day) for 90 days post-transplantation results in high patient and graft survival rates and reduces the incidence of CMV disease. Neurotoxic adverse effects are minimal. We believe that low-dose VACV prophylaxis should be considered to form one of the arms in future prospective comparison studies for the prevention of CMV disease in the high-risk D+/R- population of renal transplant patients.

Place, publisher, year, edition, pages
2013. Vol. 28, no 3, 758-765 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-190396DOI: 10.1093/ndt/gfs531ISI: 000316120000033PubMedID: 23243043OAI: oai:DiVA.org:uu-190396DiVA: diva2:583374
Available from: 2013-01-07 Created: 2013-01-07 Last updated: 2017-12-06Bibliographically approved

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Sund, FredrikTufveson, GunnarEriksson, Britt-Marie

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