The efficacy and safety of valganciclovir vs. oral ganciclovir in the prevention of symptomatic CMV infection in children after solid organ transplantation

E. Lapidus-Krol, R. Shapiro, J. Amir, M. Davidovits, R. Steinberg, E. Mor, Y. Avitzur

Research output: Contribution to journalArticlepeer-review

Abstract

Routine prophylaxis for CMV with valganciclovir is common in adult recipients but data to support its use in children are scarce. The aim of this study was to compare the efficacy and safety of valganciclovir vs. ganciclovir in a pediatric cohort. We performed a retrospective analysis of 92 children after KTx andor LTx. All children have received IV ganciclovir for two wk, and then oral ganciclovir (TID; n = 41) before 2004, or valganciclovir (OD; n = 51) thereafter. Treatment was given for three months in R+D+ or R+D- recipients and for six months in R-D+. Patients were followed for one yr post transplant. Both groups were comparable in their demographic and transplant-related history. Symptomatic CMV infectiondisease developed in 13.7% vs. 19.5% of valganciclovir and ganciclovir groups, respectively (P-NS). Time-to-onset of CMV infection was comparable in both groups (P-NS); rates of acute allograft rejection were similar in both groups (3.9% vs. 9.8%). Risk factors for CMV infection included young age, serostatus of R-D+, and allograft from cadaver donor. No significant side effects were noted in both groups. As in adults, valganciclovir appears to be as efficacious and safe as oral ganciclovir. Valganciclovir should be considered as a possible prophylactic treatment for CMV in pediatric recipients of KTx or LTx.

Original languageEnglish
Pages (from-to)753-760
Number of pages8
JournalPediatric Transplantation
Volume14
Issue number6
DOIs
StatePublished - Sep 2010

Keywords

  • antiviral prophylaxis
  • children
  • cytomegalovirus infectionsdisease
  • ganciclovirvalganciclovir
  • kidneyliver transplantation
  • risk factors

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