Gancyclovir Prophylaxis in High Risk Patients

Abstract

The aim of this study was to compare the incidence of cytomegalovirus (CMV) disease between seronegative recipients who received a CMV seropositive kidney (D+/R−) and seropositive recipients who received a CMV seropositive kidney (D+/R+). Among 42 patients included in the study, 26 were D+/R−, and the other 16 were D+/R+. Immunosuppression was based on cyclosporine (n = 12), tacrolimus (n = 28), or other agents (n = 2). Twenty-four seronegative patients were treated with gancyclovir for 3 months. The 16 D+/R+ patients did not receive CMV prophylaxis. Two D+/R− patients did not receive gancyclovir prophylaxis because of various health problems just after the surgery. Over the year post-renal transplant, there were 10 (23.8%) episodes of CMV disease. The two D+/R− patients who were not treated with gancyclovir developed CMV disease. The incidence of disease was higher in patients who were given cyclosporine (41.7% vs 17.9%). In conclusion, sero negative patients who received a kidney from a seropositive donor had greater risk of developing CMV disease. Despite gancyclovir treatment, the incidence was higher than in D+/R+ cases without treatment.