ERADICATION OF CYTOMEGALOVIRUS REACTIVATION DISEASE USING HIGH-DOSE ACYCLOVIR AND TARGETED INTRAVENOUS GANCICLOVIR IN KIDNEY AND KIDNEY PANCREAS TRANSPLANTATION/

Background. The attack rate of cytomegalovirus (CMV) is over 50% in so lid organ transplant recipients at risk for primary CMV infection and in those receiving antilymphocyte antibody therapy. Various CMV prophy laxis regimens over the last few years have reduced the attack rate to around 20% overall. Methods. We report our results using high-dose ac yclovir for 3 months after transplant, with targeted intravenous ganci clovir for the duration of any antilymphocyte antibody therapy, in our kidney and simultaneous pancreas/kidney transplant recipients. Record s of 109 consecutive patients over a 2-year period were reviewed. Resu lts. Six cases of CMV disease were identified. Five cases occurred in 21 patients at risk for primary CMV disease (24%), whereas only one ca se occurred in 73 patients at risk for CMV reactivation (1.4%). Conclu sion. We conclude that high-dose acyclovir and targeted ganciclovir is excellent prophylaxis against CMV reactivation in kidney and simultan eous pancreas/kidney transplantation.