#5364 LOW DOSE VALGANCICLOVIR AS A PRE-EMPTIVE THERAPY IS EFFECTIVE FOR CYTOMEGALOVIRUS INFECTION IN KIDNEY TRANSPLANTATION: A SINGLE-CENTER EXPERIENCE

Abstract

Abstract Background and Aims Pre-emptive therapy, screen for and treat asymptomatic cytomegalovirus (CMV) viremia, is an important preventive strategy for CMV disease in kidney transplant (KT) recipients. Oral valganciclovir is the most commonly used as preventive strategy. However, the optimal dose and treatment duration of valganciclovir remains elusive. Method We retrospectively evaluated the efficacy and toxicity of low-dose of oral valganciclovir (450 mg twice daily) as pre-emptive therapy in KT recipients who underwent KT between January 2015 and December 2021. CMV viral load was measured by polymerase chain reaction. Pre-emptive therapy with valganciclovir was applied for 2 weeks. Results of 33 kidney transplant recipients who received pre-emptive CMV therapy with valganciclovir (55 therapy cases), 32 (97.0%) were CMV seropositive except 1 patient who had no related information. Thirty-two (97.0%) received T-cell depleting agent, thymoglobulin as an induction immunosuppressive treatment. Treatment failure, defined as a CMV DNA load more than or equal to 1000 copies/mL after 2 weeks of treatment, occurred in 3 (5.45 %) patients. No patient developed CMV disease during pre-emptive therapy. The median viral copies in patients treated successfully was 487.50 (311.24 – 826.25), whereas 4420.00 (2535.00 – 137450.00) in patients who undergone treatment failure. Conclusion These results suggest that pre-emptive therapy with low dose oral valganciclovir for 2 weeks can be successfully used for preventing CMV disease among KT recipients with low-level CMV viremia. Further research is needed to replicate these findings in larger samples and assess long-term outcomes.