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Clinical outcomes of valganciclovir prophylaxis in high‐risk (D+/R−) renal transplant recipients experiencing delayed graft function
Author(s) -
Freedman Sari R.,
Ravichandran Bharath R.,
Masters Brian M.,
Bromberg Jonathan S.,
Haririan Abdolreza,
Saharia Kapil K.,
Heil Emily L.,
Sparkes Tracy
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13125
Subject(s) - valganciclovir , medicine , basiliximab , viremia , alemtuzumab , incidence (geometry) , cytomegalovirus , retrospective cohort study , cohort , transplantation , renal function , kidney transplantation , gastroenterology , urology , surgery , cytomegalovirus infection , human cytomegalovirus , immunology , virus , herpesviridae , viral disease , physics , optics
Background Cytomegalovirus (CMV) outcomes with valganciclovir prophylaxis in renal transplant recipients experiencing delayed graft function (DGF) are unclear. Methods This single center, retrospective, cohort study of CMV high‐risk (D+/R− with alemtuzumab induction) deceased donor renal transplant recipients receiving valganciclovir prophylaxis assessed CMV outcomes in patients experiencing DGF (n = 72) versus those with immediate graft function (IGF; n = 66). Results Cytomegalovirus viremia by 12 months occurred at similar rates in the IGF and DGF groups (30.3% vs 26.4%, respectively, P = 0.71) with 89.7% (35/39) of all cases classified as CMV disease. The median time to CMV viremia post transplant was day 141 and 138 in the IGF and DGF groups, respectively ( P = 0.30). The incidence of biopsy‐proven acute rejection (BPAR) was higher in the DGF group (18.1% vs 4.6%, P = 0.02) with BPAR preceding CMV in only 1 patient. There was no significant difference in graft loss (1.5% vs 4.2%, P = 0.62) or patient survival (98.5% vs 95.8%, P = 0.62) at 1 year between the IGF and DGF groups, respectively. Conclusion Valganciclovir prophylaxis in patients experiencing DGF yielded similar CMV outcomes up to 1‐year post transplant when compared to use in patients with IGF.