Post-Kidney Transplant Valacyclovir or Valganciclovir for EBV Prophylaxis: A Randomized Controlled Trial

P. S. Verghese¹, A. Matas², S. Chinnakotla², M. Evans³, H. Balfour Jr⁴

¹Pediatric Nephrology, Northwestern University, Feinberg School of Medicine, Minneapolis, MN, ²Surgery, University of Minnesota Medical School, Minneapolis, MN, ³Biostatistics, University of Minnesota, Minneapolis, MN, ⁴Lab Medicine & Pathology, University of Minnesota, Minneapolis, MN

Meeting: 2022 American Transplant Congress

Abstract number: 56

Keywords: Area-under-curve (AUC), Dosage, Ganciclovir, Reinfection

Topic: Clinical Science » Infection Disease » 24 - All Infections (Excluding Kidney & Viral Hepatitis)

Session Information

Session Name: Cytomegalovirus and other Herpes Viruses

Session Type: Rapid Fire Oral Abstract

Date: Sunday, June 5, 2022

Session Time: 3:30pm-5:00pm

Presentation Time: 4:30pm-4:40pm

Location: Hynes Ballroom B

*Purpose: EBV viremia post-kidney transplant (KTx) has no proven prophylaxis.

*Methods: In this randomized, open-label trial [NCT01329185], adult and pediatric recipients were randomly assigned (1:1) to valA or valG post-KTx. Dose was based on estimated GFR and age (as per package insert) and duration on donor-recipient serostatus. Patient outcomes were assessed. The primary end point was incidence of EBV viremia / disease.

*Results: Patients receiving valA (n=66) and valG (n=71) were similar [Table 4]. Almost all received thymoglobulin induction, rapid steroid withdrawal; tacrolimus and mycophenolate mofetil. EBV viremia occurred in 36 (26%) of the study population. The incidence of EBV viremia (24% valA and 28% valG: p=0.7), time to EBV viremia (p=0.7) and the area under the EBV load time curve (p=0.6) was not significantly different. Sub-analysis of EBV D+R- did not show difference in EBV viremia (58% in valA, 56% valG: p=1.0). There were 3 cases of PTLD: 2 were in the valA and 1 in valG.

*Conclusions: Neither valA nor valG were effective in preventing EBV viremia in pediatric /adult KTx. Impact on PTLD prevention could not be assessed due to small numbers.

To cite this abstract in AMA style:

Verghese PS, Matas A, Chinnakotla S, Evans M, Jr HBalfour. Post-Kidney Transplant Valacyclovir or Valganciclovir for EBV Prophylaxis: A Randomized Controlled Trial [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/post-kidney-transplant-valacyclovir-or-valganciclovir-for-ebv-prophylaxis-a-randomized-controlled-trial/. Accessed June 18, 2025.

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