RANDOMIZED COMPARISON OF GANCICLOVIR PLUS INTRAVENOUS IMMUNE GLOBULIN(IVIG) WITH IVIG ALONE FOR PREVENTION OF PRIMARY CYTOMEGALOVIRUS DISEASE IN CHILDREN RECEIVING LIVER-TRANSPLANTS

A randomized placebo-controlled trial was conducted to determine the b enefit of ganciclovir (5 mg/[kg.d]) for 30 days in addition to intrave nous immune globulin (IVIG) for 16 weeks for prevention of primary cyt omegalovirus (CMV) disease in children receiving liver transplants, Pa tients were monitored for 6 months after transplantation. The two grou ps of patients (recipients of 29 ganciclovir plus IVIG and 27 recipien ts of MG alone) were similar in terms of age, sex, and underlying dise ase, The incidence of CMV disease among the ganciclovir plus IVIG reci pients and the IVIG alone recipients was 17% and 26%, respectively, an d the time to disease in these recipients was 46 days and 32 days, res pectively, There was no difference between groups in terms of survival ; episodes of rejection, bacteremia, or fungemia; use of immunosuppres sive agents; and incidence of leukopenia or thrombocytopenia. These re sults suggest that a 4-week course of ganciclovir with IVIG is not mor e effective than IVIG alone for prevention of primary CMV disease, Sin ce short-term prophylaxis with ganciclovir may delay the onset of CMV disease, further studies with a longer course of ganciclovir prophylax is are warranted.