INTRAVENOUS IMMUNOGLOBULIN PROPHYLAXIS OF CYTOMEGALOVIRUS-INFECTION IN PEDIATRIC RENAL-TRANSPLANT RECIPIENTS

Cytomegalovirus (CMV), the most significant infectious cause of morbid ity following renal transplantation, may be a greater problem for chil dren than for adults due to their relative lack of experience with thi s virus. Therefore, we prospectively gave Gammagard(R) as prophylaxis to CMV-negative children who received CMV-positive allografts and comp ared the results to our experience with similar high-risk recipients t ransplanted prior to our use of intravenous immunoglobulin G (IvIgG). Symptomatic CMV disease developed in 17% of the IvIgG recipients as co mpared with 71% of the untreated patients (p = 0.01). The CMV infectio ns that did occur in IvIgG recipients developed significantly later th an in untreated children (median time of onset after transplantation 2 .60 vs. 1.35 months; p < 0.05) and generally were less severe, althoug h 1 IvIgG recipient died despite prophylaxis. IvIgG administration did not affect the frequency of rejection or graft or patient survival. W e conclude that IvIgG administration to high-risk pediatric renal tran splant recipients may protect against posttransplantation CMV disease and may lessen the severity of infections that do develop in patients who receive it.