Evaluation of cytomegalovirus prophylaxis in low and intermediate risk kidney transplant recipients receiving lymphocyte‐depleting induction

• DOI: 10.1111/tid.13573
• Publication Date: 2021-02-03T21:01:30Z
• Authors: Hillary Stamps; Kristin Linder; David M. O'Sullivan; Oscar K. Serrano; Caroline Rochon; Zeynep Ebcioglu; Joseph Singh; Xiaoyi Ye; Joseph Tremaglio; Patricia Sheiner; Faiqa Cheema; Heather L. Kutzler
• Keywords: Valganciclovir; Serostatus; Viremia; Basiliximab; Anti-thymocyte globulin; Cytomegalovirus

Abstract Cytomegalovirus (CMV) is a significant cause of morbidity in kidney transplant recipients (KTR). Historically at our institution, KTR with low and intermediate CMV risk received 6 months valganciclovir if they lymphocyte depleting induction therapy. This study evaluates choice duration prophylaxis based on donor (D) recipient (R) serostatus the incidence post‐transplant viremia (D‐/R‐) (R+) receiving lymphocyte‐depleting A protocol utilizing valacyclovir for 3 D‐/R‐ R+ was evaluated. Adult anti‐thymocyte globulin, rabbit or alemtuzumab from 8/20/2016 to 9/30/2018 were evaluated through 1 year post‐transplant. Patients excluded their D+/R‐, multi‐organ transplant, basiliximab. Seventy‐seven subjects met inclusion criteria: 25 (4 historic group, 21 experimental group) 52 (31 historic, experimental). No patients experienced viremia. Among groups, there no difference (35.5% vs 52.4%; P = .573). Of these cases, peak viral load similar between groups (median [IQR], 67 [<200‐444] <50 [<50‐217]; .711), syndrome (16.1% 14.3%; 1.000) related hospitalization (12.9% 1.000). patient tissue invasive disease. These results suggest limiting exposure may be possible therapy apparent impact CMV‐related outcomes.