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Oral Valganciclovir as a Preemptive Treatment for Cytomegalovirus (CMV) Infection in CMV-Seropositive Liver Transplant Recipients

Objectives Cytomegalovirus (CMV) infections in liver transplant recipients are common and result in significant morbidity and mortality. Intravenous ganciclovir or oral valganciclovir are the standard treatment for CMV infection. The present study investigates the efficacy of oral valganciclovir in... Full description

Journal Title: PLoS ONE May 5, 2015, Vol.10(5)
Main Author: Kim, Jong Man
Other Authors: Kwon, Choon Hyuck David , Joh, Jae-Won , Ha, Young Eun , Sinn, Dong Hyun , Choi, Gyu-Seong , Peck, Kyong Ran , Lee, Suk-Koo
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 1932-6203
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recordid: gale_ofa430193555
title: Oral Valganciclovir as a Preemptive Treatment for Cytomegalovirus (CMV) Infection in CMV-Seropositive Liver Transplant Recipients
format: Article
creator:
  • Kim, Jong Man
  • Kwon, Choon Hyuck David
  • Joh, Jae-Won
  • Ha, Young Eun
  • Sinn, Dong Hyun
  • Choi, Gyu-Seong
  • Peck, Kyong Ran
  • Lee, Suk-Koo
subjects:
  • Infection – Drug Therapy
  • Infection – Health Aspects
  • Tacrolimus – Health Aspects
  • Cytomegalovirus Infections – Drug Therapy
  • Cytomegalovirus Infections – Health Aspects
  • Bilirubin – Health Aspects
  • Liver Diseases – Drug Therapy
  • Liver Diseases – Health Aspects
  • Organ Transplant Recipients – Drug Therapy
  • Organ Transplant Recipients – Health Aspects
  • Mycophenolate Mofetil – Health Aspects
  • Liver Transplantation – Health Aspects
  • Ganciclovir – Health Aspects
ispartof: PLoS ONE, May 5, 2015, Vol.10(5)
description: Objectives Cytomegalovirus (CMV) infections in liver transplant recipients are common and result in significant morbidity and mortality. Intravenous ganciclovir or oral valganciclovir are the standard treatment for CMV infection. The present study investigates the efficacy of oral valganciclovir in CMV infection as a preemptive treatment after liver transplantation. Methods Between 2012 and 2013, 161 patients underwent liver transplantation at Samsung Medical Center. All patients received tacrolimus, steroids, and mycophenolate mofetil. Patients with CMV infection were administered oral valganciclovir (VGCV) 900mg/day daily or intravenous ganciclovir (GCV) 5mg/kg twice daily as preemptive treatment. Stable liver transplant recipients received VGCV. Results Eighty-three patients (51.6%) received antiviral therapy as a preemptive treatment because of CMV infection. The model for end-stage liver disease (MELD) score and the proportions of Child-Pugh class C, hepatorenal syndrome, and deceased donor liver transplantation in the CMV infection group were higher than in the no CMV infection group. Sixty-one patients received GCV and 22 patients received VGCV. The MELD scores in the GCV group were higher than in the VGCV group, but there were no statistical differences in the pretransplant variables between the two groups. AST, ALT, and total bilirubin levels in the GCV group were higher than in the VGCV group when CMV infection occurred. The incidences of recurrent CMV infection in the GCV and VGCV groups were 14.8% and 4.5%, respectively (P=0.277). Conclusion Oral valganciclovir is feasible as a preemptive treatment for CMV infection in liver transplant recipients with stable graft function.
language: eng
source:
identifier: ISSN: 1932-6203
fulltext: fulltext
issn:
  • 1932-6203
  • 19326203
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titleOral Valganciclovir as a Preemptive Treatment for Cytomegalovirus (CMV) Infection in CMV-Seropositive Liver Transplant Recipients
creatorKim, Jong Man ; Kwon, Choon Hyuck David ; Joh, Jae-Won ; Ha, Young Eun ; Sinn, Dong Hyun ; Choi, Gyu-Seong ; Peck, Kyong Ran ; Lee, Suk-Koo
ispartofPLoS ONE, May 5, 2015, Vol.10(5)
identifierISSN: 1932-6203
subjectInfection – Drug Therapy ; Infection – Health Aspects ; Tacrolimus – Health Aspects ; Cytomegalovirus Infections – Drug Therapy ; Cytomegalovirus Infections – Health Aspects ; Bilirubin – Health Aspects ; Liver Diseases – Drug Therapy ; Liver Diseases – Health Aspects ; Organ Transplant Recipients – Drug Therapy ; Organ Transplant Recipients – Health Aspects ; Mycophenolate Mofetil – Health Aspects ; Liver Transplantation – Health Aspects ; Ganciclovir – Health Aspects
descriptionObjectives Cytomegalovirus (CMV) infections in liver transplant recipients are common and result in significant morbidity and mortality. Intravenous ganciclovir or oral valganciclovir are the standard treatment for CMV infection. The present study investigates the efficacy of oral valganciclovir in CMV infection as a preemptive treatment after liver transplantation. Methods Between 2012 and 2013, 161 patients underwent liver transplantation at Samsung Medical Center. All patients received tacrolimus, steroids, and mycophenolate mofetil. Patients with CMV infection were administered oral valganciclovir (VGCV) 900mg/day daily or intravenous ganciclovir (GCV) 5mg/kg twice daily as preemptive treatment. Stable liver transplant recipients received VGCV. Results Eighty-three patients (51.6%) received antiviral therapy as a preemptive treatment because of CMV infection. The model for end-stage liver disease (MELD) score and the proportions of Child-Pugh class C, hepatorenal syndrome, and deceased donor liver transplantation in the CMV infection group were higher than in the no CMV infection group. Sixty-one patients received GCV and 22 patients received VGCV. The MELD scores in the GCV group were higher than in the VGCV group, but there were no statistical differences in the pretransplant variables between the two groups. AST, ALT, and total bilirubin levels in the GCV group were higher than in the VGCV group when CMV infection occurred. The incidences of recurrent CMV infection in the GCV and VGCV groups were 14.8% and 4.5%, respectively (P=0.277). Conclusion Oral valganciclovir is feasible as a preemptive treatment for CMV infection in liver transplant recipients with stable graft function.
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titleOral Valganciclovir as a Preemptive Treatment for Cytomegalovirus (CMV) Infection in CMV-Seropositive Liver Transplant Recipients.
descriptionObjectives Cytomegalovirus (CMV) infections in liver transplant recipients are common and result in significant morbidity and mortality. Intravenous ganciclovir or oral valganciclovir are the standard treatment for CMV infection. The present study investigates the efficacy of oral valganciclovir in CMV infection as a preemptive treatment after liver transplantation. Methods Between 2012 and 2013, 161 patients underwent liver transplantation at Samsung Medical Center. All patients received tacrolimus, steroids, and mycophenolate mofetil. Patients with CMV infection were administered oral valganciclovir (VGCV) 900mg/day daily or intravenous ganciclovir (GCV) 5mg/kg twice daily as preemptive treatment. Stable liver transplant recipients received VGCV. Results Eighty-three patients (51.6%) received antiviral therapy as a preemptive treatment because of CMV infection. The model for end-stage liver disease (MELD) score and the proportions of Child-Pugh class C, hepatorenal syndrome, and deceased donor liver transplantation in the CMV infection group were higher than in the no CMV infection group. Sixty-one patients received GCV and 22 patients received VGCV. The MELD scores in the GCV group were higher than in the VGCV group, but there were no statistical differences in the pretransplant variables between the two groups. AST, ALT, and total bilirubin levels in the GCV group were higher than in the VGCV group when CMV infection occurred. The incidences of recurrent CMV infection in the GCV and VGCV groups were 14.8% and 4.5%, respectively (P=0.277). Conclusion Oral valganciclovir is feasible as a preemptive treatment for CMV infection in liver transplant recipients with stable graft function.
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titleOral Valganciclovir as a Preemptive Treatment for Cytomegalovirus (CMV) Infection in CMV-Seropositive Liver Transplant Recipients.
authorKim, Jong Man ; Kwon, Choon Hyuck David ; Joh, Jae-Won ; Ha, Young Eun ; Sinn, Dong Hyun ; Choi, Gyu-Seong ; Peck, Kyong Ran ; Lee, Suk-Koo
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abstractObjectives Cytomegalovirus (CMV) infections in liver transplant recipients are common and result in significant morbidity and mortality. Intravenous ganciclovir or oral valganciclovir are the standard treatment for CMV infection. The present study investigates the efficacy of oral valganciclovir in CMV infection as a preemptive treatment after liver transplantation. Methods Between 2012 and 2013, 161 patients underwent liver transplantation at Samsung Medical Center. All patients received tacrolimus, steroids, and mycophenolate mofetil. Patients with CMV infection were administered oral valganciclovir (VGCV) 900mg/day daily or intravenous ganciclovir (GCV) 5mg/kg twice daily as preemptive treatment. Stable liver transplant recipients received VGCV. Results Eighty-three patients (51.6%) received antiviral therapy as a preemptive treatment because of CMV infection. The model for end-stage liver disease (MELD) score and the proportions of Child-Pugh class C, hepatorenal syndrome, and deceased donor liver transplantation in the CMV infection group were higher than in the no CMV infection group. Sixty-one patients received GCV and 22 patients received VGCV. The MELD scores in the GCV group were higher than in the VGCV group, but there were no statistical differences in the pretransplant variables between the two groups. AST, ALT, and total bilirubin levels in the GCV group were higher than in the VGCV group when CMV infection occurred. The incidences of recurrent CMV infection in the GCV and VGCV groups were 14.8% and 4.5%, respectively (P=0.277). Conclusion Oral valganciclovir is feasible as a preemptive treatment for CMV infection in liver transplant recipients with stable graft function.
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doi10.1371/journal.pone.0123554
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date2015-05-05