ArticleOpen forum infectious diseases2024
Multicenter Analysis of Valganciclovir Prophylaxis in Pediatric Solid Organ Transplant Recipients.
Article in Open forum infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Beyond valganciclovir: A meta-analysis of letermovir's safety and efficacy in cytomegalovirus prophylaxis after solid organ transplantation.BMC infectious diseases · 2026Pooled it
- Infection prophylaxis following anti-CD20 monoclonal antibodies in childhood kidney diseases.Pediatric nephrology (Berlin, Germany) · 2026Review
- Optimization of Valganciclovir for Treatment of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients: A Prospective Pharmacokinetic Study.Transplantation direct · 2026Article
- Immunosenescence and cancer predisposition in pediatric transplant recipients: An emerging paradigm.World journal of transplantation · 2026Review
- Cytomegalovirus Infection of the Anterior Segment: Corneal Endotheliitis and Secondary Glaucoma.Pathogens (Basel, Switzerland) · 2026Review
- Debates in Management and Treatment of CMV in Pediatric Solid Organ Transplant Recipients: A Case-Based Discussion.Pediatric transplantation · 2025Review
- Low Absolute Lymphocyte Count Associated With Anti-Thymocyte Globulin Induction May Be a Predictor of Early Cytomegalovirus Infection in Pediatric Heart Transplantation.Pediatric transplantation · 2025Article
- A Matched Case-Control Study to Evaluate Predicted Drug Exposures and Neutropenia during Valganciclovir Prophylaxis in Pediatric Solid Organ Transplant Recipients.Transplant infectious disease : an official journal of the Transplantation SocietyArticle
Corrections and comments
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Valganciclovir is the only approved antiviral for cytomegalovirus (CMV) prevention in pediatric solid organ transplantation (SOT). Additional approaches may be needed to improve outcomes. Methods: A multicenter retrospective study from 2016 to 2019 was conducted of pediatric SOT recipients in whom at least 3 months of valganciclovir prophylaxis was planned. Episodes of CMV DNA in blood (DNAemia), CMV disease, drug-related toxicities, as well as other infections in the first year posttransplant and demographic and clinical data were collected. CMV DNAemia in the first year after prophylaxis or during prophylaxis (breakthrough) was analyzed by multivariate hazard models. Results: Among the 749 patients enrolled, 131 (17.5%) had CMV DNAemia at any time in the first year; 85 (11.4%) had breakthrough DNAemia, and 46 (6.1%) had DNAemia after prophylaxis. CMV disease occurred in 30 (4%). In a multivariate model, liver transplantation compared to kidney or heart, intermediate or high risk based on donor/recipient serologies, neutropenia, and valganciclovir dose modifications attributed to toxicity were associated with increased risk of total and/or breakthrough DNAemia. Bacteremia was also associated with increased hazard ratio for CMV DNAemia. In a separate multivariate analysis, rejection occurred more often in those with breakthrough CMV DNAemia ( Conclusions: CMV DNAemia in the first year posttransplantation occurs despite valganciclovir prophylaxis and is associated with medication toxicity, bacteremia, and rejection. Pediatric studies of newer antivirals, especially in higher-risk subpopulations, appear to be warranted.
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