Ganciclovir Treatment of Serious Cytomegalovirus Infection in Heart and Heart-Lung Transplant Recipients

Experience with ganciclovir treatment of life- or sight-threatening cytomegalovirus (CMV) infections in 22 heart and heart-lung transplant recipients at six medical centers was reviewed. All six heart-lung recipients and six of 16 heart recipients had CMV pneumonitis; five heart recipients had CMV g...

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Bibliographic Details
Published in:Reviews of infectious diseases 1988-07, Vol.10, p.S563-S572
Main Authors: Keay, Susan, Petersen, Eskild, Timothy Icenogle, Barry J. Zeluff, Tobias Samo, David Busch, Cheryl L. Newman, William C. Buhles, Jr, Merigan, Thomas C.
Format: Article
Language:English
Subjects:
Acyclovir - adverse effects
Acyclovir - analogs & derivatives
Acyclovir - therapeutic use
Adolescent
Adult
Antiviral Agents - adverse effects
Antiviral Agents - therapeutic use
Child, Preschool
Cytomegalovirus
Cytomegalovirus Infections - drug therapy
Dosage
Female
Ganciclovir
Gastroenteritis - drug therapy
Heart
Heart lung transplantation
Heart Transplantation
Humans
Immunosuppression
Infections
Lung Transplantation
Lungs
Male
Middle Aged
Multicenter Studies as Topic
Pneumonia
Pneumonia, Viral - drug therapy
Postoperative Complications - drug therapy
Relapse
Retinitis - drug therapy
Transplantation
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Summary:Experience with ganciclovir treatment of life- or sight-threatening cytomegalovirus (CMV) infections in 22 heart and heart-lung transplant recipients at six medical centers was reviewed. All six heart-lung recipients and six of 16 heart recipients had CMV pneumonitis; five heart recipients had CMV gastrointestinal disease, three had retinitis, and two had infections in more than one organ system. Of the 18 patients (82%) surviving initial ganciclovir therapy, 16 improved, one stabilized, and one showed no change in clinical status. All cultures positive for CMV before treatment became negative during therapy. Six patients (33% of survivors) had recurrent episodes and received additional therapy. Four patients (18%) died during initial therapy; death was believed to be related to CMV infection in only two cases and to ganciclovir treatment in no case. Adverse reactions possibly attributable to ganciclovir included neutropenia (four patients), impaired renal function (one), thrombocytopenia (one), decreased blood pressure (one), and seizure (one). Ganciclovir appears to be well tolerated and to alter favorably the outcome of serious CMV infection in this patient population.
ISSN:0162-0886