Acyclovir/cytomegalovirus immune globulin combination therapy for CMV prophylaxis in high-risk renal allograft recipients.

CYTOMEGALOVIRUS (CMV) remains a common complication after renal transplantation. As previously reported. CMV has a significant impact not only on the clinical outcome after transplantation but also on its cost; for patients with CMV. cost is increased 2.9-fold as a result of extended hospitalization. I The risk of developing CMV disease after renal transplantation is highest in seronegative patients who receive grafts from seropositive donors (R-D+). In this population, the incidence of CMV -associated morbidity approaches 60%. Numerous strategies have been employed to prevent CMV disease after transplantation. including the exclusion of antibody-positive donors for antibody-negative recipients," active immunization .... ;th CMV-attenuated vaccines,J passive immunization with CMV immunoglobulin (CMVIg).4 and antiviral chemotherapy including high-dose acyclovir (ACV),5 gancyciovir.o and interferon.7 Although each agent has achieved some success, none has successfully eliminated the virus.