Hello,
Thank you for your query at DoctorSpring.com
Donor positivity with CMV can pose a problem to the recipient after the transplant. CMV can lead to several complications including loss of graft ( new kidney). Hence it should be treated aggressively in the form of ' prophylactic therapy'. As such , the donor is unrelated and would be given ' valgancyclovir' sicne the day of transplantation. Valgancyclovir should be given for at least 100 days after transplant and few centers might give it upto 200 days also. Some times , Gancyclovir also would be given. As the transplanation is living related here, you also can treat the donor before hand itself so that the viremia can come down ( Inj Gancyclovir or tablet valcyclovir for 21 days at least before transplantation. The less the viremia the better the prognosis.
Feel free to discuss further,
Regards
Patient replied :
Doctor
we have fix the transplant on 07.11.14 as suggested by doctor.as per nephrology donor cmv igm is 1.06 which is on broder line , no problem ------whether this is correct
as per nephrology,tab valcyte 450 to be taken by receipitant from 05.11.14 & to continue for 6 months after operation also.
please suggest what to be done at stage which will be helpful for my wife good health.
tab valcyte 450 can be taken by receipitant is ok?? & for donor what to be done at this stage.whether we can postpone by taking medicines as suggest by you sir.
Pl help
--Bhima Raju
Hello,
No problem. You can go ahead with transplant as I said that she would require valgancyclovir for 200 days after transplant. Usually living transplant with unrelated donor (like cousin),would require the drug even otherwise as they would receive induction ( higher immunosuppressive drugs) therapy at the time of transplantation.
You can plan accordingly and best wishes to you
Let me know if i can ehlp you further,
Regards.
Patient replied :
thank u doctor for ur valuable suggestion.
My wife suffering CKD from 2005 & under dialysis from past 3 yrs.
i am worried about my wife health & finally arranged amount ,planned for transplant but donor found with CMV IgM positive which put in worry.
It gods gift which has help me in getting suggestion from you doctor & once more heartfull thanks for giving suggestion & motivation.
We required ur blessing to my wife.
---Bhima Raju
Hello Mr.Bhima,
Thank you for your appreciation.
I totally understand what you're going through.
But she will be fine.
Let me know after the transplant.
God bless!!
Patient replied :
good evening doctor
with ur blessing--my wife kidney transplantation completed & she is under medication.
presently Sr cretatine manitaning 1 to 1.2.but
total leucocytes count is 13.86 *1000 --report says WBC mild neutrophilic leukocytosis present--any problem with this
presently tab valgan ,wysolone-15 mg,neroal-100 mg (3 nos per day),azoran , rantac 150 mg ( 2 nos),amtas2.5mg( depending upon BP),vitamin tablets taken as per timming given by doctor.
i planning to meet u sir personally doctor after my wife recovering
please suggest doctor
Bhimaraju
9949976172
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