Oral valganciclovir &lt;i&gt;versus&lt;/i&gt; intravenous ganciclovir as preemptive treatment for cytomegalovirus infection after living donor liver transplantation: A randomized trial

Togashi, Junichi; Sugawara, Yasuhiko; Hashimoto, Masao; Tamura, Sumihito; Kaneko, Junichi; Aoki, Taku; Hasegawa, Kiyoshi; Kokudo, Norihiro

doi:10.5582/bst.2011.v5.5.217

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…In addition, 15 noncomparative observational studies were included in this meta‐analysis. The results on dose, duration and route of administration of GCV/VGCV along with follow‐up and CMV diagnostic methods are reported in Tables and .…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, there were three RCTs for the UP strategy comparing the efficacy of two antivirals in diverse combination (IV GCV vs. per oral [PO] GCV, PO GCV vs. acyclovir, and PO GCV vs. PO VGCV). Similarly, there were five RCTs for the PE strategy comparing two antivirals in diverse combinations (PO GCV vs. no treatment, PO GCV vs. IV GCV, IV GCV vs. PO VGCV, and two comparing PO GCV vs. placebo).…”

Section: Resultsmentioning

confidence: 99%

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Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Mumtaz

Faisal

Husain

et al. 2015

American Journal of Transplantation

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We systematically reviewed and meta-analyze the efficacy of universal prophylaxis (UP) and preemptive (PE) strategies (using ganciclovir or valganciclovir) in preventing cytomegalovirus (CMV) disease (CMD) among liver transplant recipients (LTRs). We performed an electronic search of MEDLINE, EMBASE and the Cochrane Database till December 2013. Studies that assessed UP or PE for preventing CMD in LTRs were included. The risk of bias was assessed using the Newcastle-Ottawa scale. The primary outcome was CMD, secondary outcomes being acute cellular rejection (ACR), graft loss (GL) and mortality. Due to the heterogeneity of comparative studies, an indirect comparison was performed. Pooled incidence rates with 95% confidence interval (CI) are calculated for each outcome using a random-effects model. Thirty-two studies involving 2456 LTRs were included. The majority of the studies were of low risk of bias. Irrespective of donor/recipient CMV sero-status, CMD was 10% with UP (95% CI: 6-14; I 2 ¼ 87%; 16 studies, n ¼ 1581) and 7% with PE (95% CI: 3-10; I 2 ¼ 84%; 16 studies, n ¼ 875) (mean difference 2.6; 95% CI: À3.25 to 8.45, p ¼ 0.34). Likewise, ACR and mortality were similar with the two strategies. However, GL was significantly lower in the UP group, regardless of donor/recipient sero-status. In indirect comparison, the incidence of CMD, ACR and mortality in LTRs were similar with two strategies. Trials comparing the two strategies directly are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Mumtaz

Faisal

Husain

et al. 2015

American Journal of Transplantation

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“…We measured plasma 1,3‐β‐D glucan on a regular basis after surgery, and pre‐emptive antifungal treatment (fluconazole administered intravenously and trimethoprim–sulfamethoxazole) was started . The pp65 antigenemia assay was employed to detect cytomegalovirus (CMV) infection . Thrombotic microangiopathy can be complicated after LDLT , so therapeutic plasma exchange therapy was introduced immediately when this problem was diagnosed from laboratory tests.…”

Section: Methodsmentioning

confidence: 99%

Chronic renal outcome after living donor liver transplantation

Nishi

Shibagaki

Kido

et al. 2012

Clinical Transplantation

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Chronic kidney disease (CKD) is one of the common complications after deceased donor liver transplantation. Although the worldwide pressing shortage in deceased donors has directed attention to living donor liver transplantation (LDLT), LDLT cohort data focusing on chronic renal dysfunction is limited. A total of 280 adult LDLT recipients (median 49 yr, 156 men) at the University of Tokyo hospital between 1996 and 2006 were reviewed. A total of 224 pre-transplant liver failure patients (80.0%) showed an estimated glomerular filtration rate (eGFR) of more than 60 mL/min/1.73 m(2). However, during follow-up at a mean of 1222 d after transplantation, eGFR declined to 60 mL/min/1.73 m(2) and 30 mL/min/1.73 m(2) in 150 (53.2%) and 21 (7.5%), respectively, and four patients (1.4%) required maintenance renal replacement therapy. Multivariate Cox proportional hazard model regression analysis revealed that recipient age (HR, 3.42 per 10-yr increment; p < 0.001) and pre-transplant eGFR (HR, 0.85 per 10-mL/min/1.73 m(2) increment; p = 0.04) were associated independently with a post-transplant decrease in eGFR to less than 30 mL/min/1.73 m(2). We conclude that higher age and lower pre-transplant eGFR of an LDLT recipient indicate a high likelihood of subsequent development of advanced CKD. Preventive or therapeutic intervention should be optimized for these high-risk patients.

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“…В терапии обычно используется ганцикловир внутривенно или валган-цикловир внутрь [45], клинические результаты при-менения которых имеют схожие результаты [68].…”

Section: лечение цмвиunclassified

Clinical Significance of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients

Tsiroulnikova

Жилкин

Ахаладзе

2016

RJTAO

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1 ФГБУ «Федеральный научный центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация 2 Кафедра трансплантологии и искусственных органов ГБОУ ВПО «Первый МГМУ им. И.М. Сеченова», Москва, Российская Федерация Трансплантация печени является единственным возможным путем лечения многих форм хронических заболеваний печени терминальной стадии у детей. Цитомегаловирус -наиболее распространенная и зна-чимая инфекция у детей после трансплантации печени с развитием эпизодов ЦМВ-инфекции (ЦМВИ) или ЦМВ-заболевания. ЦМВИ ассоциирована с повышенным риском потери трансплантата. В обзоре литературы представлены такие аспекты, как этиология и эпидемиология ЦМВИ после транспланта-ции печени детям, применяемые подходы диагностики и профилактики ЦМВИ, алгоритмы дозирования валганцикловира, а также методы профилактики осложнений течения ЦМВИ. Также представлены по-следние данные о текущих стратегиях профилактики ЦМВИ в мировой практике.Ключевые слова: трансплантация печени детям, цитомегаловирусная инфекция, профилактика цитомегаловирусной инфекции. Liver transplantation is a life-saving procedure for many forms of end-stage liver disease in pediatrics. Cytomegalovirus (CMV) is the most common and signifi cant posttransplant infection after pediatric liver transplant (PLT) with developing an episode of CMV infection or disease. It is well known that CMV increases risk of graft loss. The review presents aspects of etiology and epidemiology of CMV after PLT, approaches employed in diagnostics and prophylaxis of CMV, algorithms for valganciclovir dosing and methods to prevent complications associated with CMV. The latest data on current prevention strategies in pediatric liver transplantation centers in the world are also presented. CLINICAL SIGNIFICANCE OF CYTOMEGALOVIRUS INFECTION IN PEDIATRIC LIVER TRANSPLANT RECIPIENTS

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Oral valganciclovir <i>versus</i> intravenous ganciclovir as preemptive treatment for cytomegalovirus infection after living donor liver transplantation: A randomized trial

Cited by 13 publications

References 18 publications

Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Chronic renal outcome after living donor liver transplantation

Clinical Significance of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients

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