Article
Transplantation
Rachel Hellemans, Daniel Abramowicz
Summary: CMV-related complications after kidney transplantation present a significant challenge. Tailoring preventive strategies based on individual patient risk levels can improve outcomes. CMV-specific T-cell assays can help predict CMV risk pre-transplantation. Immunosuppressive regimens including mammalian target of rapamycin inhibitors can reduce CMV risk. New antiviral agents and adoptive T-cell therapy hold promise for future treatment options.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2022)
Review
Immunology
Narisa Ruenroengbun, Tunlanut Sapankaew, Kamolpat Chaiyakittisopon, Pakpoom Phoompoung, Thundon Ngamprasertchai
Summary: This study evaluated and ranked the drugs for allograft rejection prevention following CMV prophylaxis in high-risk kidney transplant patients. Valganciclovir was considered the most effective and safest drug, while valacyclovir was the optimal alternative. Dose-related toxicities and patient compliance should be closely monitored.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Hematology
Po-Hsien Li, Cheng-Hsien Lin, Yu-Hui Lin, Tsung-Chih Chen, Chiann-Yi Hsu, Chieh-Lin Jerry Teng
Summary: The study suggests that low-dose valganciclovir prophylaxis may be an effective strategy to prevent CMV infection in patients undergoing allo-HSCT, particularly in resource-limited countries.
THERAPEUTIC ADVANCES IN HEMATOLOGY
(2021)
Article
Immunology
Danielle Ecabert, Christine Pham, Brett J. Pierce, William L. Musick, Duc T. Nguyen, Edward A. Graviss
Summary: In non-kidney transplant recipients, the study found that valganciclovir 450 mg three times weekly post-HD had similar rates of leukopenia, neutropenia, thrombocytopenia, and CMV infection compared to valganciclovir dosed per renal function.
OPEN FORUM INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Jorge Andrade-Sierra, Alejandro Heredia-Pimentel, Enrique Rojas-Campos, Diana Ramirez Flores, Jose Cerrillos-Gutierrez, Alejandra G. Miranda-Diaz, Luis A. Evangelista-Carrillo, Petra Martinez-Martinez, Basilio Jalomo-Martinez, Eduardo Gonzalez-Espinoza, Benjamin Gomez-Navarro, Miguel Medina-Perez, Juan Jose Nieves-Hernandez
Summary: In renal transplant recipients, low doses of ATG may increase the risk of developing CMV, while the use of basiliximab may be more favorable. Additionally, factors such as lack of prophylaxis, ATG use, tacrolimus toxicity, and lymphocyte count at the sixth month post-transplantation are associated with the risk of CMV.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2021)
Article
Immunology
Andrew S. Jarrell, Jessica R. Crow, Sara E. Strout, Rachel M. Kruer, Lindsey P. Toman, Maria Dioverti-Prono, Laura Lees, Robin K. Avery, Mark A. Marzinke
Summary: Valganciclovir 450 mg enterally every 24 hours achieved ganciclovir trough concentrations >= 0.60 mu g/mL in most patients on CVVHD, similar to those reported with intravenous ganciclovir for prophylaxis in this population. Neutropenia did not occur in the study period. Thrombocytopenia was common and likely multifactorial.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Urology & Nephrology
Louis Maniere, Johan Noble, Florian Terrec, Hamza Naciri Bennani, Eloi Chevallier, Benedicte Janbon, Raphaele Germi, Mathilde Bugnazet, Farida Imerzoukene, Paolo Malvezzi, Lionel Rostaing, Thomas Jouve
Summary: The study found that administering everolimus plus low-dose tacrolimus to de novo kidney-transplant recipients was associated with low rates of CMV disease, especially in R+ patients without CMV prophylaxis.
INTERNATIONAL UROLOGY AND NEPHROLOGY
(2021)
Review
Immunology
Dipesh Kumar Yadav, Vishnu Prasad Adhikari, Rajesh Kumar Yadav, Alina Singh, Xing Huang, Qi Zhang, Prabesh Pandit, Qi Ling, Tingbo Liang
Summary: This meta-analysis compared the outcomes of antiviral prophylaxis and preemptive therapy for the prevention of cytomegalovirus (CMV) infection in liver transplant recipients. The results showed that antiviral prophylaxis reduced the incidence of CMV infection in the high-risk group, while preemptive therapy reduced the incidence of late-onset CMV disease. There were no significant differences in other outcomes between the two interventions.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Biology
Markus J. Barten, Fausto Baldanti, Alexander Staus, Christian M. Hueber, Kyriaki Glynou, Andreas Zuckermann
Summary: This meta-analysis suggests that prophylactic CMVIG treatment in solid organ transplantation patients can reduce the risk of CMV infection. This is particularly beneficial for patients at high risk of CMV infection or disease.
Article
Urology & Nephrology
Tomas Reischig, Tomas Vlas, Martin Kacer, Kristyna Pivovarcikova, Daniel Lysak, Jana Nemcova, Petr Drenko, Jana Machova, Mirko Bouda, Monika Sedivcova, Stanislav Kormunda
Summary: This study compared the efficacy of valganciclovir prophylaxis and preemptive therapy in preventing CMV infection in kidney transplant recipients. The results showed that both regimens had similar effectiveness in preventing CMV disease, but preemptive therapy had a higher incidence of CMV DNAemia.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2023)
Article
Surgery
Maura L. L. Kreiser, Robert Dupuis, Kristen R. R. Szempruch, Laura M. M. Chargualaf
Summary: This study compared the efficacy of different doses of valganciclovir prophylaxis in liver transplant recipients and found no significant difference between the reduced dose and full dose groups in terms of incidence of CMV infection, neutropenia, or leukopenia, although the time to diagnosis of CMV was different.
CLINICAL TRANSPLANTATION
(2023)
Article
Urology & Nephrology
Takaya Iida, Kenichiro Miura, Hideki Ban, Taro Ando, Yoko Shirai, Sho Ishiwa, Atsutoshi Shiratori, Naoto Kaneko, Tomoo Yabuuchi, Kiyonobu Ishizuka, Masanori Takaiwa, Kazuhide Suyama, Masataka Hisano, Motoshi Hattori
Summary: This study analyzed high-risk pediatric patients who received oral VGCV prophylaxis at Tokyo Women's Medical University from August 2018 to March 2019. Results showed that all patients received a dose of 450 mg, but most required dose reduction or discontinuation due to adverse events, and all patients developed late-onset CMV disease with no seroconversion observed during prophylaxis. Further studies are needed to investigate the safety and efficacy of VGCV prophylaxis in Japanese pediatric recipients.
CLINICAL AND EXPERIMENTAL NEPHROLOGY
(2021)
Review
Surgery
Narisa Ruenroengbun, Pawin Numthavaj, Tunlanut Sapankaew, Kamolpat Chaiyakittisopon, Atiporn Ingsathit, Gareth J. Mckay, John Attia, Ammarin Thakkinstian
Summary: This study compared and ranked the efficacy and safety of different antiviral agents for preventing CMV infection/disease in adult kidney transplant recipients. Results showed that prophylactic valganciclovir (VGC) significantly lowered the risks of CMV infection and disease, followed by ganciclovir (GC). Valacyclovir (VAC) could be considered as an alternative prophylactic option.
TRANSPLANT INTERNATIONAL
(2021)
Article
Pharmacology & Pharmacy
Wieteke Kleinherenbrink, Marije Baas, Gizal Nakhsbandi, Dennis A. Hesselink, Joke Roodnat, Brenda C. de Winter, Luuk Hilbrands, Teun van Gelder
Summary: The study found that delayed graft function and rejection significantly increased the risk of CMV disease in renal transplant recipients. Valganciclovir prophylaxis may not provide sufficient protection for CMV IgG-seronegative recipients receiving a kidney from CMV IgG-seropositive donor, especially those with delayed graft function.
PHARMACOLOGICAL RESEARCH
(2021)
Article
Immunology
Alexandra L. Bixby, Linda Fitzgerald, Jeong M. Park, Daniel Kaul, Sarah Tischer
Summary: For CMV D+/R- LT recipients, VGCV 900 mg/day for 180 days had higher rates of hematologic adverse effects resulting in frequent treatment interruptions. However, the occurrence of two cases of GCV-resistant CMV disease raises concerns about routinely using low-dose VGCV prophylaxis.
TRANSPLANT INFECTIOUS DISEASE
(2021)