ノート
肺移植患者における腎機能に応じたバルガンシクロビル予防投与の検討
キーワード:
valganciclovir prophylaxis,
leukopenia,
renal dysfunction,
cytomegalovirus,
lung transplantation
2018 年 44 巻 6 号 p. 299-304
詳細
2018 年 44 巻 6 号 p. 299-304
In principle, valganciclovir (VGCV) should be used to treat patients who develop Cytomegalovirus (CMV) infections after lung transplants. The main adverse event of VGCV is leukopenia. However, the risk factors for VGCV-induced leukopenia have not been clarified. In this study, we examined the risk factors for VGCV-induced leukopenia. It is suggested that age, positivity for CMV antigenemia, interstitial pneumonia, and the patient's renal function before the administration of VGCV are strongly associated with VGCV-induced leukopenia. In addition, during examinations of the relationships between renal function or the VGCV dose and leukopenia it became clear that relatively high doses of VGCV were administered in the leukopenia group compared with the non-leukopenia group despite the fact that the former group exhibited low renal function. In conclusion, it is important to gradually adjust the dose of VGCV to 450 mg/day, 450 mg every other day, or 450 mg three times a week according to the patient's renal function in order to prevent leukopenia.
