{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:52:56Z","timestamp":1777420376412,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,8,26]],"date-time":"2017-08-26T00:00:00Z","timestamp":1503705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>Background: Following abdominal solid organ transplant (aSOT), valganciclovir (VGC) is recommended for cytomegalovirus (CMV) prophylaxis. This agent is associated with efficacy concerns, toxicity, and emergence of ganciclovir resistance. Objective: To evaluate the incidence of high-dose acyclovir (HD-A) prophylaxis failure in seropositive aSOT recipients (R+). Methods: This was a retrospective, single-center study of R+ transplanted without lymphocyte-depleting induction between January 1, 2000, and June 30, 2013, discharged with 3 months of HD-A prophylaxis (800 mg 4 times daily). The primary outcome was incidence of prophylaxis failure. Secondary outcomes were incidence of biopsy-proven tissue-invasive disease and prophylaxis failure for each allograft subgroup. Results: A total of 1525 patients met inclusion criteria: 944 renal (RTX), 108 simultaneous pancreas-kidneys (SPK), 462 liver (LTX), and 11 pancreas (PTX) transplant recipients. The composite rate of HD-A prophylaxis failure was 7%; incidence of tissue-invasive disease was 0.4%. Failure rates were 4.5%, 6.1%, 11%, and 20% in the RTX, SPK, LTX, and PTX populations, respectively; tissue-invasive disease rates were 0.2%, 0%, 0.7%, and 10%. Failure occurred more frequently in the LTX and PTX populations ( P &lt; 0.0001, HR = 2.6; P = 0.04 HR = 4.4). Incidence of tissue-invasive disease was minimal and not different in the RTX, LTX and SPK populations ( P = 0.34). When evaluating recipients of seronegative allografts (D\u2212), the composite failure rate was 3.4% with no significant difference between allograft subgroups ( P = 0.45). Conclusion: HD-A may be a reasonable prophylaxis alternative for D\u2212\/R+ recipients, in the absence of lymphocyte-depleting induction, if low incidence viremia is tolerable. Future studies are needed to determine the long-term impact of CMV viremia in the setting of this prophylaxis approach.<\/jats:p>","DOI":"10.1177\/1060028017728296","type":"journal-article","created":{"date-parts":[[2017,8,26]],"date-time":"2017-08-26T07:12:49Z","timestamp":1503731569000},"page":"5-10","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["High-Dose Acyclovir for Cytomegalovirus Prophylaxis in Seropositive Abdominal Transplant Recipients"],"prefix":"10.1177","volume":"52","author":[{"given":"Margaret R.","family":"Jorgenson","sequence":"first","affiliation":[{"name":"University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian L.","family":"Descourouez","sequence":"additional","affiliation":[{"name":"University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glen E.","family":"Leverson","sequence":"additional","affiliation":[{"name":"University of Wisconsin-Madison School of Medicine and Public Health, Department of Surgery, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin K.","family":"McCreary","sequence":"additional","affiliation":[{"name":"University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Lucey","sequence":"additional","affiliation":[{"name":"University of Wisconsin-Madison School of Medicine and Public Health, Department of Medicine, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannina A.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Wisconsin-Madison School of Medicine and Public Health, Department of Medicine, Madison, WI, 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