High-dose acyclovir and intravenous immune globulin reduce the incidence of CMV disease after liver transplantation

Eytan Mor, Burt R. Meyers, Ozgur Yagmur, Keiji Kishikawa, Patricia A. Sheiner, Sukru Emre, Myron E. Schwartz, Charles M. Miller

Research output: Contribution to journalArticlepeer-review

Abstract

We attempted to prevent cytomegalovirus (CMV) disease in liver transplant (LTx) recipients by means of a combined prophylaxis regimen consisting of high-dose acyclovir (HDA) and immune globulin (IVIG). In 259 consecutive patients, HDA was given for 3 months post-LTx; recipients seronegative for CMV also received IVIG. The previous 94 patients comprised our control group; in this group, low dose acyclovir was given to prevent herpes, and prophylaxis of CMV consisted of IVIG given only to seronegative recipients of seropositive donors. The overall incidence of CMV disease was lower in the HDA group (10.8%) than in the control group (27.6%); (P<0.001). The CMV disease rate associated with primary exposure was 26.3% in the HDA group and 83.3% in the control group (P<0.001). The incidence of CMV disease occurring after acute rejection was 9.5% in HDA patients and 24.6% in controls (P<0.005) The HDA protocol was associated with a trend toward a lower incidence of CMV in patients requiring OKT3 therapy (16.7% vs 29%). High-dose acyclovir/IVIG thus reduces the incidence of CMV disease in seronegative recipients after LTx and lowers the risk of CMV disease associated with therapy for rejection.

Original languageEnglish
Pages (from-to)152-156
Number of pages5
JournalTransplant International
Volume8
Issue number2
DOIs
StatePublished - Mar 1995
Externally publishedYes

Keywords

  • Acyclovir, CMV, liver transplantation
  • Cytomegalovirus, liver transplantation
  • Immune globulin, acyclovir, CMV, liver transplantation

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