Strategies for CMV prevention in CMV D+/R– transplant recipients
| Characteristic | Kidney (n=31) | Liver (n=25) | Heart (n=8) | Lung (n=8) |
|---|---|---|---|---|
| None | 3 (10) | 2 (8) | 0 | 0 |
| Prophylaxis | 10 (32) | 7 (28) | 5 (63) | 3 (38) |
| Valacyclovir (oral) | 3 (10) | 0 | 0 | 0 |
| Valganciclovir (oral) | 7 (23) | 7 (28) | 5 (63) | 3 (38) |
| Duration of prophylaxis (mo) | 3 (2‒6) | 3 (1‒3) | 3 (1‒3) | 6 (3‒6) |
| Prophylaxis+preemptive strategy | 12 (39) | 7 (28) | 3 (38) | 5 (63) |
| Valacyclovir (oral)+qPCR monitoring | 4 (13) | 0 | 0 | 0 |
| Ganciclovir (intravenous)+qPCR monitoring | 0 | 1 (4) | 0 | 0 |
| Valganciclovir (oral)+qPCR monitoring | 7 (23) | 6 (24) | 2 (25) | 5 (63) |
| Cut-off value of qPCR for preemptive therapy initiation (copies or IU/mL) | 1,000 (34.5‒10,000) | 1,000 (34.5‒10,000) | 10,000 (10,000–10,000) | 3,500 (1,000–10,000) |
| Valganciclovir (oral)+antigenemia monitoring | 1 (3) | 0 | 1 (13) | 0 |
| Cut-off value of antigenemia for preemptive therapy initiation (no./200,000 WBC) | 25 | 0 | 1 | 0 |
| Duration of prophylaxis (mo) | 3 (3‒6) | 2 (0.5‒6) | 3 (3‒3) | 6 (3‒6) |
| Duration of preemptive monitoring (mo) | 8 (5‒24) | 9 (1‒12) | 12 (6‒12) | 12 (6‒48) |
| Preemptive strategy | 6 (19) | 9 (36) | 0 | 0 |
| Preemptive strategy based on qPCR | 6 (19) | 6 (24) | 0 | 0 |
| Cut-off value of qPCR for preemptive therapy initiation (copies or IU/mL) | 1,000 (34.5‒1,000) | 1,000 (500‒10,000) | 0 | 0 |
| Preemptive strategy based on antigenemia | 0 | 3 (12) | 0 | 0 |
| Cut-off value of antigenemia for preemptive therapy initiation (no./200,000 WBC) | 0 | 4 (1‒5) | 0 | 0 |
| Duration of preemptive monitoring (mo) | 12 (3‒12) | 3 (1‒12) | 0 | 0 |
Values are presented as number (%) or median (range).
CMV, cytomegalovirus; qPCR, quantitative polymerase chain reaction; WBC, white blood cell.