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

Détails

ID Serval
serval:BIB_90C644532B8E
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Disposition of oral valganciclovir during continuous renal replacement therapy in two lung transplant recipients
Titre de la conférence
8th American Transplant Congress
Auteur(s)
Perrottet Nancy, Robatel Corinne, Meylan Pascal, Pascual Manuel, Venetz Jean-Pierre, Aubert John-David, Berger Mette M., Decosterd Laurent A., Biollaz Jerome, Buclin Thierry
Adresse
Toronto, Canada, May 31-June 4, 2008
ISBN
1600-6135
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
8
Série
American Journal of Transplantation
Pages
566
Langue
anglais
Notes
Publication type : Meeting Abstract
Résumé
Background: Oral valganciclovir (VGC) is hydrolysed into active ganciclovir (GCV) which is eliminated in the kidney by filtration and secretion. VGC dosage has to be adapted in renal failure with continuous renal replacement therapy (CRRT), a condition
sometimes encountered early after solid organ transplantation. This investigation aimed to determine whether VGC 450 mg every 48 hours provides appropriate GCV exposure for cytomegalovirus (CMV) prophylaxis during CRRT.
Methods: GCV pharmacokinetics were extensively studied during CRRT in two lung transplant recipients with acute renal failure receiving VGC 450 mg every 48 hours trough a nasogastric tube. In vitro experiments using blank whole blood spiked with GCV further investigated exchanges between plasma and erythrocytes.
Results: GCV disposition was characterised by an area under the curve (AUC) of 98.0 and 55.4 mg h/L, resulting in trough concentrations of 0.7 and 0.2 mg/L, an apparent total body clearance of 3.3 and 5.8 L/h, a terminal half-life of 16.9 and 14.1 h, and an apparent volume of distribution of 60.3 and 104.9 L. The observed sieving coefficient (filtrate/plasma) was 1.05 and 0.96, and the hemofiltration clearance 3.3 and 3.1 L/h, respectively. High sieving values could be explained by an efflux of GCV from erythrocytes. In vitro experiments confirmed that erythrocytes are loaded with significant GCV amount and release it quickly into plasma, thus contributing to the apparent efficacy of hemofiltration.
Conclusion: These results indicate that a VGC dosage of 450 mg every 48 hours was adequate for CMV prophylaxis during CRRT, providing GCV levels similar to those reported using 900 mg qd in transplant recipients with normal renal function.
Mots-clé
,
Web of science
Création de la notice
29/12/2010 9:46
Dernière modification de la notice
20/08/2019 14:54
Données d'usage