Preemptive Therapy to Prevent CMV Disease in Liver Transplant Recipients

In a randomized trial, less cytomegalovirus disease occurred with preemptive therapy than with universal prophylaxis.

Most transplant centers employ one of two cytomegalovirus (CMV) prevention strategies. In universal prophylaxis, all at-risk recipients receive valganciclovir, typically for 3 to 6 months. A preemptive approach, which is more complicated to implement but may reduce drug costs and toxicity as well as late disease, involves periodically measuring quantitative CMV DNA levels via polymerase chain reaction (qPCR) and administering valganciclovir when a prespecified level is exceeded. Guidelines recommend either strategy in liver or kidney recipients (Transplantation 2018 Jun; 102:900). Now, a randomized trial compares the two strategies.

A total of 205 liver transplant recipients (CMV seronegative, with seropositive donors) were assigned to eithe…

Reviewing Author

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Preemptive Therapy to Prevent CMV Disease in Liver Transplant Recipients

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Reviewing Author