Efficacy and safety of a lower-dose valganciclovir (valcyte) regimen for cytomegalovirus prophylaxis in kidney and pancreas transplant recipients.

PURPOSE We evaluated the efficacy and safety of the current cytomegalovirus (CMV) prophylaxis regimen used at Virginia Mason Medical Center in Seattle. METHODS A single-center, retrospective analysis was conducted in a regional renal transplantation center at a tertiary teaching facility. STUDY POPULATION Seventy patients who underwent kidney and/or pancreas transplantation from October 2006 through December 2008 were observed for a period of six months after the procedure. Transplant recipients at risk for developing CMV disease received valganciclovir 450 mg daily. RESULTS Outcome measures were incidence of CMV disease and incidence of severe leukopenia during the six-month postoperative period. Of 70 patients, seven (10%) developed CMV disease and five (7.1%) developed severe leukopenia while taking valganciclovir. Based on donor (D) and recipient (R) CMV serostatus, the incidence of CMV disease and severe leukopenia incidence was highest in the D+/R- group. Severe leukopenia developed in one patient with CMV disease who had a D+/R-kidney transplant. No statistical calculations were performed. CONCLUSION The current lower-dose valganciclovir regimen at our institution was found to be efficacious and safe, and it provided significant cost savings.