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Abstract: SA-PO1061

Valacyclovir for Prevention of Cytomegalovirus Infection After Kidney Transplantation

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Kim, Jin sug, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul, Korea (the Republic of)
  • Yoon, Soo-Young, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul, Korea (the Republic of)
  • Kim, Dae Kyu, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul, Korea (the Republic of)
  • Lee, Hyo Jin, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul, Korea (the Republic of)
  • Kim, Yang Gyun, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)
  • Moon, Ju young, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)
  • Hwang, Hyeon Seok, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul, Korea (the Republic of)
  • Jeong, Kyunghwan, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul, Korea (the Republic of)
Background

Cytomegalovirus (CMV) infection is a frequent and devastating complication after kidney transplantation (KT). Although guidelines recommend anti-viral prophylaxis with ganciclovir or valganciclovir, there is a demand for alternative regimen for CMV prevention. We investigated the effects of valacyclovir-based prophylaxis for 3 months on CMV infection and clinical outcomes in KT recipients using a nationwide cohort.

Methods

2,584 KT recipients from 20 transplant centers registered with the Korean Organ Transplantation Registry were analyzed in this study. The recipients were divided into two groups according to valacyclovir prophylaxis (valacyclovir prophylaxis group and non-prophylaxis group). The impact of valacyclovir-based prophylaxis on CMV infection and disease, and clinical outcomes including rejection, graft loss, cardiac events, and all-cause mortality were investigated. Risk factors for the development of CMV infection were also analyzed.

Results

Valaciclovir prophylaxis group showed significantly lower incidence of CMV infection and rejection compared to non-prophylaxis group (3.64 vs. 10.25 events per 100 person-years and 1.85 vs. 7.27 events per 100 person-years, respectively). The risk of CMV infection and rejection was significantly decreased in valaciclovir prophylaxis group compared to non-prophylaxis group. Valacyclovir prophylaxis, donor age, whether deceased donor or not, length of hospitalization after KT, anti-thymocyte globulin usage, and CMV serological mismatch between the donor and the recipient (donor+ and recipient−) were independent risk factors for the development of CMV infection.

Conclusion

Valacyclovir prophylaxis after KT significantly reduced CMV infection and rejection. Valacyclovir could be considered as an alternative strategy for CMV prophylaxis after KT. Well-designed randomized controlled trials with large sample size are needed.