Prophylaxis of cytomegalovirus primary infection with short-term ganciclovir theraphy

Abstract

CYTOMEGALOVIRUS (CMV) remains one of the most important pathogens in kidney and other solid organ transplantation. It produces greater morbility nowadays rather than the significant mortality rates in the past. CMV not only produces direct damage due to the infection, but also indirect complications including excessive immunosuppression and augmented acute rejection as well as decreasing patient and allograft survivals and increasing economic costs. The most important risk factors for CMV infection are recipient CMV serologic status in relation to organ donor serology (D /R ), and the use of antilymphocyte antibodies either for induction or for acute rejection therapy. There are two major forms of CMV infection; prophylaxis by administration of antiviral drugs or gammaglobulins at the time of transplantation and for a variable period after transplantation, and preemptive therapy, namely giving antiviral drugs when there is evidence of the virus replication after kidney transplantation. We report our experience with a group of high risk patients (D /R ) who received low-dose and short-term gancyclovir prophylaxis.