{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:27:14Z","timestamp":1790083634463,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T00:00:00Z","timestamp":1630195200000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to compare the safety and efficacy of two valganciclovir (VGCV) institutional dosing protocols for cytomegalovirus (CMV) prophylaxis in liver transplant (LT) recipients with CMV serotype donor +\/recipient\u2010 (D+\/R\u2212).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center review of CMV D+\/R\u2212 adult LT recipients who received VGCV 450\u00a0mg\/day for 90 days (low\u2010dose) or VGCV 900\u00a0mg\/day for 180 days (standard\u2010dose). The primary outcome was incidence of CMV disease at 1 year. Secondary outcomes included rates of CMV syndrome, end\u2010organ disease, breakthrough infection, and resistance. Neutropenia, early discontinuation of VGCV, growth colony stimulating factors use (G\u2010CSF), biopsy\u2010proven rejection (BPAR), graft loss, and death at 1 year were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010six CMV D+\/R\u2212 LT recipients were included. Although no difference in CMV disease was observed (low\u2010dose 26%\u00a0vs. standard\u2010dose 23%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.71), 75% of CMV infections in the low\u2010dose group presented with end\u2010organ disease. Ganciclovir (GCV) resistance was observed only in the low\u2010dose group (<jats:italic>n<\/jats:italic>\u00a0=\u00a02). Significantly more patients in the standard\u2010dose group developed neutropenia (low\u2010dose 10%\u00a0vs 60% standard\u2010dose, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In the standard\u2010dose group, 29% required early discontinuation of VGCV (vs. 5% in the low\u2010dose group, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and 20% were treated with G\u2010CSF. Both cohorts had similar rates of BPAR, graft loss, and death at 1 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>VGCV 900\u00a0mg\/day for 180 days had higher rates of hematologic adverse effects resulting in frequent treatment interruptions. However, the occurrence of two cases of GCV\u2010resistant CMV disease raises concerns about routinely using low\u2010dose VGCV prophylaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13713","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T16:49:50Z","timestamp":1629823790000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Comparison of standard versus low\u2010dose valganciclovir regimens for cytomegalovirus prophylaxis in high\u2010risk liver transplant recipients"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1869-5202","authenticated-orcid":false,"given":"Alexandra L.","family":"Bixby","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Michigan Medicine  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong M.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Michigan Medicine  Ann Arbor Michigan USA"},{"name":"Department of Clinical Pharmacy University of Michigan College of Pharmacy  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0990-4148","authenticated-orcid":false,"given":"Daniel","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases Michigan Medicine  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Tischer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Michigan Medicine  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14208"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14195"},{"key":"e_1_2_9_6_1","unstructured":"Highlights of prescribing information.Hoffmann\u2010La Roche Limited. Product Monograph Valcyte.2010.http:\/\/www.gene.com\/gene\/products\/information\/valcyte\/pdf\/pi.pdf. 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