Disposition of valganciclovir during continuous renal replacement therapy in two lung transplant recipients.

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Serval ID
serval:BIB_FB953C5B3D78
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Disposition of valganciclovir during continuous renal replacement therapy in two lung transplant recipients.
Journal
Journal of Antimicrobial Chemotherapy
Author(s)
Perrottet N., Robatel C., Meylan P., Pascual M., Venetz J.P., Aubert J.D., Berger M.M., Decosterd L.A., Buclin T.
ISSN
1460-2091[electronic], 0305-7453[linking]
Publication state
Published
Issued date
2008
Volume
61
Number
6
Pages
1332-1335
Language
english
Notes
Publication types: Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
Abstract
OBJECTIVES: To determine whether valganciclovir 450 mg every 48 h for cytomegalovirus (CMV) prophylaxis provides appropriate ganciclovir exposure in solid organ transplant recipients during continuous renal replacement therapy (CRRT).
PATIENTS AND METHODS: Ganciclovir pharmacokinetics was intensively studied in two lung transplant recipients under valganciclovir 450 mg every 48 h over one dosing interval. In vitro experiments using blank whole blood spiked with ganciclovir further investigated exchanges between plasma and erythrocytes.
RESULTS: Ganciclovir disposition was characterized by apparent total body clearance of 3.3 and 5.8 L/h, terminal half-life of 16.9 and 14.1 h, and apparent volume of distribution of 60.3 and 104.9 L in Patients 1 and 2, respectively. The observed sieving coefficient was 1.05 and 0.96, and the haemofiltration clearance was 3.3 and 3.1 L/h. In vitro experiments confirmed rapid efflux of ganciclovir from red blood cells into plasma, increasing the apparent efficacy of haemofiltration.
CONCLUSIONS: A valganciclovir dosage of 450 mg every 48 h appears adequate for patients under CRRT requiring prophylaxis for CMV infection, providing concentration levels in the range reported for 900 mg once daily dosing outside renal failure.
Keywords
Chemoprevention/methods, Cytomegalovirus Infections/prevention & control, Ganciclovir/administration & dosage, Ganciclovir/analogs & derivatives, Half-Life, Humans, Lung Transplantation, Male, Metabolic Clearance Rate, Middle Aged, Renal Replacement Therapy
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2009 23:13
Last modification date
25/09/2019 7:11
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