Abstract | BACKGROUND: The use of T-cell-depleting antibody, such as thymoglobulin, is a risk factor for cytomegalovirus (CMV) infection. We studied the effectiveness of 6 months of low-dose valganciclovir prophylaxis in CMV-naive kidney transplant recipients of CMV-positive donor kidney (D+/R-) receiving thymoglobulin induction. METHODS: We included all D+/R- kidney transplant patients between October 2005 and December 2010 who received valganciclovir 450 mg daily for 6 months as per center protocol. CMV infection was confirmed by positive viremia. Kaplan-Meier and multivariate Cox proportional regression analyses were employed to compare the risk of CMV infection between patients with and without the use of thymoglobulin induction. RESULTS: Out of 170 D+/R- kidney transplant patients, 42 cases of CMV infection (24.6%) were diagnosed after a median follow-up of 3.2 years: six patients from the noninduction (9.4%) and 36 from the induction cohort (34.0%). The induction with thymoglobulin was associated with four times greater risk of developing CMV infection (adjusted hazard ratio: AHR 4.15, 95% 1.75, 9.86, P = .001). The use of thymoglobulin was associated with leukopenia but not neutropenia. CONCLUSIONS: Additional measures are needed to reduce the elevated incidence of CMV infection in D+/R- kidney transplant patients receiving induction with thymoglobulin.
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Authors | F L Luan |
Journal | Transplantation proceedings
(Transplant Proc)
2013 Jan-Feb
Vol. 45
Issue 1
Pg. 175-7
ISSN: 1873-2623 [Electronic] United States |
PMID | 23267799
(Publication Type: Journal Article)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Antilymphocyte Serum
- Antiviral Agents
- Immunosuppressive Agents
- thymoglobulin
- Valganciclovir
- Ganciclovir
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Topics |
- Adult
- Antilymphocyte Serum
(immunology)
- Antiviral Agents
(therapeutic use)
- Cohort Studies
- Cytomegalovirus
- Cytomegalovirus Infections
(complications, drug therapy, prevention & control)
- Female
- Ganciclovir
(analogs & derivatives, therapeutic use)
- Humans
- Immunosuppressive Agents
- Kidney Failure, Chronic
(surgery)
- Kidney Transplantation
(methods)
- Leukopenia
(etiology)
- Male
- Middle Aged
- Neutropenia
(etiology)
- Proportional Hazards Models
- Regression Analysis
- Retrospective Studies
- Risk Factors
- Time Factors
- Tissue Donors
- Treatment Outcome
- Valganciclovir
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