Shen G K, Alfrey E J, Knoppel C L, Dafoe D C, Scandling J D
Multi-Organ Transplant Center, Stanford University Medical Center, California 94305, USA.
Transplantation. 1997 Sep 27;64(6):931-3. doi: 10.1097/00007890-199709270-00026.
The attack rate of cytomegalovirus (CMV) is over 50% in solid organ transplant recipients at risk for primary CMV infection and in those receiving antilymphocyte antibody therapy. Various CMV prophylaxis regimens over the last few years have reduced the attack rate to around 20% overall.
We report our results using high-dose acyclovir for 3 months after transplant, with targeted intravenous ganciclovir for the duration of any antilymphocyte antibody therapy, in our kidney and simultaneous pancreas/kidney transplant recipients. Records of 109 consecutive patients over a 2-year period were reviewed.
Six cases of CMV disease were identified. Five cases occurred in 21 patients at risk for primary CMV disease (24%), whereas only one case occurred in 73 patients at risk for CMV reactivation (1.4%).
We conclude that high-dose acyclovir and targeted ganciclovir is excellent prophylaxis against CMV reactivation in kidney and simultaneous pancreas/kidney transplantation.
在有原发性巨细胞病毒（CMV）感染风险的实体器官移植受者以及接受抗淋巴细胞抗体治疗的患者中，CMV的感染率超过50%。在过去几年中，各种CMV预防方案已将总体感染率降低至约20%。
我们报告了在肾移植以及胰肾联合移植受者中，移植后使用高剂量阿昔洛韦3个月，并在任何抗淋巴细胞抗体治疗期间使用靶向静脉注射更昔洛韦的结果。回顾了2年期间109例连续患者的记录。
确定了6例CMV疾病。5例发生在21例有原发性CMV疾病风险的患者中（24%），而仅1例发生在73例有CMV再激活风险的患者中（1.4%）。
我们得出结论，高剂量阿昔洛韦和靶向更昔洛韦是预防肾移植以及胰肾联合移植中CMV再激活的极佳方法。
