{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:34:50Z","timestamp":1773030890396,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Problem<\/jats:title><jats:p>Mathematical modeling suggests aggressive ganciclovir dosing in the first week of cytomegalovirus disease (CMV) treatment may improve response. This has not been evaluated clinically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult kidney and\/or pancreas transplant recipients admitted with CMV (4\/29\/19\u20137\/15\/20) received IV ganciclovir(10\u00a0mg\/kg Q12\u00a0h\u00a0\u00d7\u00a07\u00a0days) with step\u2010down to standard\u2010of\u2010care (SOC) dosing thereafter (5\u00a0mg\/kg Q12). A SOC cohort admitted before implementation of the dosing strategy (10\/20\/16\u20133\/2\/19) served as a comparator. Primary objective: rate of viral clearance (delta log CMV) at therapy day 7. Secondary objective: safety\/short term efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010four patients met inclusion criteria; 22 high\u2010dose, 32 SOC. Demographics were similar with the exception of more women (45.4%\u00a0vs. 15.6%,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) and higher presenting viral\u2010load in the high\u2010dose group (log 6.0\u00b1.7\u00a0vs. log 5.2\u00b11.2, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). High\u2010dose resulted in significantly greater response to therapy at day 7 (log \u2010.92\u00b1.51\u00a0vs. log \u2010.56\u00b1.79, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). Change in WBC at day 7 was not different (\u2010.49\u00b11.92\u00a0vs. \u2010.45\u00b15.1, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.97). Short\u2010term clinical outcomes were similar between groups including mean hospital length\u2010of\u2010stay (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.52), readmission rates (30\u00a0d: <jats:italic>P<\/jats:italic>\u00a0=\u00a0.38; 90\u00a0d: <jats:italic>P<\/jats:italic>\u00a0=\u00a0.5) and achievement of CMV viral\u2010load less\u2010than\u2010lower\u2010limit\u2010of\u2010quantification by day 90 (73%\u00a0vs. 84%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.06). Rejection after CMV as well as graft\/patient survival were similar between groups (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.56, <jats:italic>P<\/jats:italic>\u00a0&gt;\u00a0.99, <jats:italic>P<\/jats:italic>\u00a0&gt;\u00a0.99).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A high\u2010dose IV ganciclovir strategy results in improved viral clearance kinetics without safety concerns and similar short term clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14427","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T10:51:31Z","timestamp":1626346291000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A pilot study of an intensified ganciclovir dosing strategy for treatment of cytomegalovirus disease in kidney and\/or pancreas transplant recipients"],"prefix":"10.1111","volume":"35","author":[{"given":"Margaret R.","family":"Jorgenson","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian L.","family":"Descourouez","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glen E.","family":"Leverson","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Saddler","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannina A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neetika","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandesh","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier A.","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon S.","family":"Odorico","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Transplantation University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199806113382407"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_10_5_1","unstructured":"Ganciclovir. 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