Trial reportJournal of the American Society of Nephrology : JASN2012
Long-term outcomes of pre-emptive valganciclovir compared with valacyclovir prophylaxis for prevention of cytomegalovirus in renal transplantation.
Trial report in Journal of the American Society of Nephrology : JASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Pre-emptive treatment for cytomegalovirus viraemia to prevent cytomegalovirus disease in solid organ transplant recipients.The Cochrane database of systematic reviews · 2025Pooled it
- Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients.The Cochrane database of systematic reviews · 2024Pooled it
- Exploring failure of antimicrobial prophylaxis and pre-emptive therapy for transplant recipients: a systematic review.BMJ open · 2020Pooled it
- Pre-emptive treatment for cytomegalovirus viraemia to prevent cytomegalovirus disease in solid organ transplant recipients.The Cochrane database of systematic reviews · 2013Pooled it
- Less renal allograft fibrosis with valganciclovir prophylaxis for cytomegalovirus compared to high-dose valacyclovir: a parallel group, open-label, randomized controlled trial.BMC infectious diseases · 2018Trial
- Randomized trial of valganciclovir versus valacyclovir prophylaxis for prevention of cytomegalovirus in renal transplantation.Clinical journal of the American Society of Nephrology : CJASN · 2015Trial
- Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study.Transplant international : official journal of the European Society for Organ Transplantation · 2025Observational
- Prevention of Cytomegalovirus Infection in Solid Organ Transplant Recipients: Guidelines by the Korean Society of Infectious Diseases and the Korean Society for Transplantation.Infection & chemotherapy · 2024Review
- A Systematic Review and Meta-analysis of Optimized CMV Preemptive Therapy and Antiviral Prophylaxis for CMV Disease Prevention in CMV High-Risk (D+R-) Kidney Transplant Recipients.Transplantation direct · 2023Article
- National survey of prevention and management of CMV infection in pediatric kidney transplantation in comparison to clinical practice guidelines.Frontiers in pediatrics · 2022Article
- Recent Advancement in Nanotechnology-Based Drug Delivery System Against Viral Infections.AAPS PharmSciTech · 2021Review
- Prevention of cytomegalovirus infection after solid organ transplantation: a Bayesian network analysis.Annals of clinical microbiology and antimicrobials · 2020Article
- Usefulness of valacyclovir prophylaxis for cytomegalovirus infection after anti-thymocyte globulin as rejection therapy.The Korean journal of internal medicine · 2019Article
- Heterologous Cytomegalovirus and Allo-Reactivity by Shared T Cell Receptor Repertoire in Kidney Transplantation.Frontiers in immunology · 2019Observational
- Characterization and clinical enrichment of HLA-C*07:02-restricted Cytomegalovirus-specific CD8+ T cells.PloS one · 2018Article
- Article
- [Specific infections in organ transplantation].Der Internist · 2016Review
- Cytomegalovirus infection in transplant recipients.Clinics (Sao Paulo, Brazil) · 2015Review
- Clinical Applications of Quantitative Real-Time PCR in Virology.Methods in microbiology · 2015Article
- Direct and Indirect Effects of Cytomegalovirus-Induced γδ T Cells after Kidney Transplantation.Frontiers in immunology · 2015Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prevention of cytomegalovirus (CMV) is essential in organ transplantation. The two main strategies are pre-emptive therapy, in which one screens for and treats asymptomatic CMV viremia, and universal antiviral prophylaxis. We compared these strategies and examined long-term outcomes in a randomized, open-label, single-center trial. We randomly assigned 70 renal transplant recipients (CMV-seropositive recipient or donor) to 3-month prophylaxis with valacyclovir (n=34) or pre-emptive valganciclovir for significant CMV viremia detected at predefined assessments through month 12 (n=36). Among the 55 patients who had a protocol biopsy specimen available at 3 years to allow assessment of the primary outcome, 9 (38%) of 24 patients in the prophylaxis group and 6 (19%) of 31 patients in the pre-emptive therapy group had moderate to severe interstitial fibrosis and tubular atrophy (odds ratio, 2.50; 95% confidence interval, 0.74-8.43; P=0.22). The prophylaxis group had significantly higher intrarenal mRNA expression of genes involved in fibrogenesis. The occurrence of CMV disease was similar in both groups, but pre-emptive therapy improved 4-year graft survival (92% versus 74%; P=0.049) as a result of worse outcomes in patients with late-onset CMV viremia. In conclusion, compared with valacyclovir prophylaxis, pre-emptive valganciclovir therapy may lead to less severe interstitial fibrosis and tubular atrophy and to significantly better graft survival.
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