Efficacy and safety of low-dose valganciclovir prophylaxis among renal transplant recipients

Purpose: Cytomegalovirus (CMV) infection is one of the most common infections observed following kidney transplantations. Transplantations between cytomegalovirus (Immunoglobulin G)-seropositive donor and CMV-seropositive recipient (D+/R+) are considered to be of moderate risk. In our study, we investigated the efficacy of low-dose (450 mg/g) valganciclovir in CMV chemoprophylaxis in renal transplant patients over their first post-transplant year. Materials and Methods: A total of 68 consecutive patients aged over 18 years who underwent renal transplantation between January 2016 and June 2019 were included in this retrospective study. All patients were administered valganciclovir 450 mg/g, for 100 days. The efficacy of low-dose valganciclovir was determined by whether the patients developed a CMV disease during their first post-transplant year. Results: Only one patient (n=1/68) (1.5%) developed CMV disease. CMV DNA titer was positive on post-transplant day 134 of the patient who had unexplained loss of GFR. CMV disease-related acute rejection, graft loss, leukopenia, post-transplant diabetes mellitus, opportunistic infection, or patient loss was not observed. Conclusion: There are many studies comparing CMV prophylaxis with low and standard dose (450 vs. 900 mg/g) valganciclovir treatment in transplant patients. The results of this study show that low-dose valganciclovir is sufficient for the prophylaxis of CMV disease in D+/R+ medium-risk patients without leading to any side effects. Further clinical studies with larger patient participation are needed.