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KMID : 0361120200340010015
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Korean Journal of Transplantation
2020 Volume.34 No. 1 p.15 ~ p.23
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Effectiveness of valacyclovir prophylaxis against the occurrence of cytomegalovirus infection in kidney transplant recipients
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Park Woo-Yeong
Kim Yae-Rim
Paek Jin-Hyuk
Jin Kyu-Bok
Park Sung-Bae
Han Seung-Yeup
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Abstract
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Background: Cytomegalovirus (CMV) infection is a crucial infection in kidney transplant recipients (KTRs) despite advancements in diagnostic and treatment methods. There are still many controversies about the ways to prevent CMV infection.
Methods: We retrospectively analyzed 153 KTRs who underwent kidney transplantation (KT) between September 2013 and January 2016. We classified KTRs into two groups: valacyclovir prophylaxis group (intravenous ganciclovir for 2 weeks after KT, followed by oral valacyclovir for 3 months) and historical control group (only intravenous ganciclovir for 2 weeks after KT). We evaluated the incidence of CMV infection, clinical outcomes, CMV-free survival rate between the two groups and risk factors for the development of CMV infection.
Results: Mean time between KT and diagnosis of CMV infection was 4.5±3.3 months. The valacyclovir prophylaxis group showed lower incidence of CMV infection than the historical control group (21.7% vs. 43.9%, P=0.011). The valacyclovir prophylaxis group showed higher CMV-free survival rate than the control group (P=0.011). In multivariable- adjusted analysis, independent risk factors for the development of CMV infection were no valacyclovir prophylaxis, older age at KT, thymoglobulin induction, and delayed graft function.
Conclusions: Valacyclovir prophylaxis for 3 months showed significant reduction in the incidence of CMV infection in KTRs. Therefore, we suggest valacyclovir prophylaxis for 3 months in KTRs with risk factors such as old age, thymoglobulin induction, and delayed graft function.
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KEYWORD
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Antibiotic prophylaxis, Antithymocyte serum, Cytomegalovirus infections, Kidney transplantation, Risk factors
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