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Randomized trial of ganciclovir (GAN) followed by high dose oral acyclovir (HD-ACY) vs. GAN alone in the prevention of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) after pediatric liver transplantation (PLTx).

Green M, Reyes J, Nour B, Kaufmann M, Geraci L, Beatty D, Wilson J, Todo S, Tzakis A; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1994 Oct 4-7; 5.

Univ of Pittsburgh Sch of Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA.

Prophylaxis with HD-ACY alone did not result in a decreased rate of CMV disease after PLTx at our institution. In order to determine the role of HD-ACY in the prevention of CMV and EBV disease in patients prophylaxed with GAN for the first 2 post-operative weeks, patients undergoing first-time PLTx were stratified according to donor (D) and recipient (R) serologic status against CMV and randomized to receive either HD-ACY (800 mg/m2 PO QID for 1st year post-LTx) or no HD-ACY. Between 7/92 & 3/94, 48/57 eligible patients were enrolled in the study. D/R CMV serologies in these children were: D+/R- 13, D-/R+ 11, D+/R+ 7, D-/R- 17. 45/48 are alive 1 to 20 months after PLTx. CMV disease was diagnosed in 6/24 pts on HD-ACY compared with 2/24 controls (p=N.S.). For D+/R- recipients, CMV disease was seen in 4/7 HD-ACY pts compared to 0/6 controls (p=0.07). Rates of EBV disease were 6/24 vs. 5/24 (HD-ACY vs. control). We conclude that HD-ACY does not decrease CMV or EBV disease after PLTx. The trend towards an increased rate of CMV among children treated with HD-ACY was an unexpected & intriguing finding.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Acyclovir
  • Child
  • Clinical Trials as Topic
  • Cytomegalovirus
  • Cytomegalovirus Infections
  • Ganciclovir
  • Herpesvirus 4, Human
  • Humans
  • Immunization, Passive
  • Kidney Transplantation
  • Liver Transplantation
  • Pancreas Transplantation
  • Tissue Donors
  • surgery
  • therapy
  • transplantation
Other ID:
  • 95920682
UI: 102213631

From Meeting Abstracts




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