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| |  Abbreviated Pre-Emptive Monitoring as Effective as Valganciclovir at Preventing Cytomegalovirus in Kidney Transplant Patients: Presented at ATC By Thomas S. May TORONTO -- June 2, 2008 -- An abbreviated pre-emptive approach to monitoring for cytomegalovirus (CMV) is easier to implement than the weekly monitoring and as effective at preventing CMV in kidney transplant patients who are at moderate risk of infection, according to a study presented here at the 2008 American Transplant Congress (ATC). Weekly CMV monitoring is time consuming and expensive, and it is difficult to do outside of a clinical trial, the researchers said in a poster session on May 31 by lead author David J. Taber, PharmD, Medical University of South Carolina, Charleston, South Carolina. Dr. Taber and colleagues enrolled 119 kidney transplant recipients at moderate risk for CMV. Of these, 76 patients transplanted in 2006 received valganciclovir for 3 months; another 43 patients transplanted in 2007 underwent a pre-emptive monitoring strategy, which used no anti-CMV prophylaxis and serial CMV polymerase chain reaction (PCR) in an abbreviated schedule (weeks 4, 6, 8, 10, 12, 16, 20, and 24). The 2 groups were matched with respect to baseline demographics. Results showed that the pre-emptive approach was equally effective in preventing CMV syndrome and CMV disease compared with valganciclovir, with no increased risk of rejection or early graft loss. Twelve patients in the pre-emptive group (27%) developed CMV DNAemia without any symptoms and required initiation of antiviral therapy. In addition, 66% in the pre-emptive group never required anti-CMV therapy. "This study shows that abbreviating CMV PCR monitoring to draw only 8 [measurements] is still effective, yet it's feasible to do," Dr. Taber said. He stressed that this approach is very new and not been evaluated previously. He suggested that this research could impact other centres using CMV PCR monitoring. [Presentation title: An Abbreviated Pre-Emptive Monitoring Strategy Is as Effective as Valganciclovir Prophylaxis in Preventing CMV in Moderate Risk Kidney Transplants. Abstract 692]
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