FROM TRADITION TO TRANSFORMATION: ONCE-DAILY VALGANCICLOVIR REDEFINES CMV PROPHYLAXIS IN RENAL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE / LITERATURE REVIEW

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FROM TRADITION TO TRANSFORMATION: ONCE-DAILY VALGANCICLOVIR REDEFINES CMV PROPHYLAXIS IN RENAL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE / LITERATURE REVIEW

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Co-author 1

Nosheen Anjum dr.nosheenwaqas@gmail.com KRL Hospital Nephrology Islamabad Pakistan *

Co-author 2

Zahid Nabi Dr_zahidnabi@hotmail.com KRL Hospital Nephrology Islamabad Pakistan -

Co-author 3

Zahid ul Zahideen zahideen7007@gmail.com Ali Medical Center Nephrology Islamabad Pakistan -

Co-author 4

Wasif Jamil wasif.jamil79@gmail.com Ali Medical Center Nephrology Islamabad Pakistan -

Co-author 5

Humayun Rashid dr.humayun503@gmail.com KRL Hospital Nephrology Islamabad Pakistan -

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Introduction

Cytomegalovirus (CMV) infection is a significant post-transplant complication, influencing graft survival and patient outcomes. The optimal valganciclovir dosing strategy remains variable across centers. This report describes a single-center experience using a lower prophylactic dose of 450 mg once daily (OD) for three months, comparing outcomes with standard literature-reported 450 mg twice daily (BD) regimens.

Methods

Renal transplant recipients (350) at our center from 2020–2025 were administered valganciclovir 450 mg Once Daily (OD) for three months post-transplantation as CMV prophylaxis. Patients were monitored for CMV viremia, leukopenia, graft function, and treatment tolerance. Observed outcomes were compared to published data on higher-dose (BD) regimens.

Results

Among all patients receiving the OD regimen, no clinically significant CMV infection occurred during the prophylaxis period. Leukopenia and gastrointestinal intolerance were infrequent, and graft function remained stable. Compared to reported BD regimens, the OD protocol demonstrated similar efficacy, with better safety and cost-effectiveness.

Conclusion

A 450 mg once-daily valganciclovir regimen provides effective CMV prophylaxis with fewer hematologic side effects and lower cost, representing a safe and practical approach in resource-limited settings.

Kewords