DI-025 Valganciclovir in liver transplanted patients

Background Cytomegalovirus (CMV) infection is the most common viral infection after solid organ transplantation, and is an important cause of mortality and morbidity in this group of patients. Valganciclovir is used to treat and prevent this condition. Purpose The aim of our study was to analyse the use of valganciclovir (indication of treatment, dosage and safety) in liver transplanted patients. Material and methods Retrospective observational study that included all patients that underwent liver transplantation in 2014 in our hospital. Electronic clinical history (SELENE), the pharmacy service managing software (Farmatools) and an Excel database of transplanted patients were used to collect the information. Results 38 patients underwent liver transplantation in our hospital in 2014. 34 patients were finally included (mean age 55 years) after surviving the postoperative period. Mean length of stay in hospital was 26 days and mean discharge creatinine was 0.93 mg/dL. 11 patients (32.3%) were treated with valganciclovir, 6 (55%) as treatment against CMV and the rest as prophylaxis (CMV seropositive donor and CMV seronegative receiver). The dose used in prophylaxis was 900 mg/24 h for all patients except one who received 450 mg/24 h because of reduced kidney function; the dose used for treatment was 900 mg/12 h in all patients as none presented with kidney malfunction. 8 patients (24%) had valganciclovir included in their treatment after discharge. Mean duration of treatment with valganciclovir was 27 days (n = 6) when used as treatment and 178 days when used as prophylaxis (n = 3). 4 patients (36%) suffered from neutropenia while receiving valganciclovir, 75% (n = 3) as treatment and 25% (n = 1) as prophylaxis. Conclusion Dosage of valganciclovir should be adjusted based on the patient’s renal function, which was accomplished in all cases in our hospital. Neutropenia was more frequent in the group of patients that had received valganciclovir as treatment than in the prophylaxis group. Recommended duration of prophylaxis with valganciclovir was achieved as it was longer than 100 days in all patients. References and/or Acknowledgements Fayek SA, Mantipisitkul W, Rasetto F, Munivenkatappa R, Barth RN, Philosophe B. Valganciclovir is an effective prophylaxis for cytomegalovirus disease in liver transplant recipients Valganciclovir European Public Assessment Report No conflict of interest.