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Therapeutic use of ganciclovir for invasive cytomegalovirus infection in cadaveric renal allograft recipients.

Jordan, ML and Hrebinko, RL and Dummer, JS and Hickey, DP and Shapiro, R and Vivas, CA and Simmons, RL and Starzl, TE and Hakala, TR (1992) Therapeutic use of ganciclovir for invasive cytomegalovirus infection in cadaveric renal allograft recipients. J Urol, 148 (5). 1388 - 1392. ISSN 0022-5347

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Abstract

Between November 1987 and September 1989, 419 cadaveric renal transplants were performed at our university. Of the patients 36 (8.6%) had invasive cytomegalovirus infection documented by gastric or duodenal mucosal biopsy in 23 (64%), bronchoalveolar lavage in 12 (33%), allograft biopsy or nephrectomy specimen in 5 (14%) and/or liver biopsy in 1 (3%). Cytomegalovirus severity was defined as mild in 27 patients, moderate in 6 and severe in 3. Ganciclovir [9-(1,3-dihydroxy-2-propoxymethyl)-guanine] was begun once the diagnosis was confirmed by histology or culture at a median of 56 days from transplantation (range 28 to 133 days). Duration of ganciclovir therapy was a minimum of 7 days or until fever was absent for 5 consecutive days (mean 12.2 +/- 3.5 days, range 4 to 21). Ganciclovir was well tolerated and side effects were limited to de novo neutropenia (7 patients), thrombocytopenia (2) and rash (1). Initial clinical improvement was observed in all patients. Two patients had recurrent cytomegalovirus infections that responded to a second course of ganciclovir. The 1-year actuarial patient survival was 100%. At a mean followup of 12.7 +/- 6.2 months 19 patients retained allograft function with a mean serum creatinine of 2.5 mg./dl. (range 1.2 to 4.6). Ganciclovir appears to be a safe and effective drug for the treatment of tissue invasive cytomegalovirus infection in cadaver renal transplant recipients. Prompt institution of this drug at diagnosis of invasive cytomegalovirus may lower the mortality rate formerly associated with this disease.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Jordan, ML
Hrebinko, RL
Dummer, JS
Hickey, DP
Shapiro, R
Vivas, CA
Simmons, RL
Starzl, TEtes11@pitt.eduTES11
Hakala, TR
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: November 1992
Date Type: Publication
Journal or Publication Title: J Urol
Volume: 148
Number: 5
Page Range: 1388 - 1392
Institution: University of Pittsburgh
Refereed: Yes
Uncontrolled Keywords: Adolescent, Adult, Aged, Cadaver, Cytomegalovirus Infections, Female, Ganciclovir, Graft Rejection, Humans, Immunosuppressive Agents, Kidney Transplantation, Male, Middle Aged, Postoperative Complications, Recurrence, Survival Rate
ISSN: 0022-5347
Funders: NIDDK NIH HHS (R01 DK029961-19)
Other ID: uls-drl:31735062112267, Starzl CV No. 1437
Date Deposited: 08 Apr 2010 17:24
Last Modified: 13 Oct 2017 19:55
URI: http://d-scholarship.pitt.edu/id/eprint/4823

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