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NDT Plus 2009 2(2):149-151; doi:10.1093/ndtplus/sfp004
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leflunomide: a treatment option for ganciclovir-resistant cytomegalovirus infection after renal transplantation

Joachim Andrassy1, Wilf Dieter Illner1, Markus Rentsch1, Gundula Jaeger3, Karl W. Jauch1 and Michael  Fischereder2

1 Department of Surgery, Ludwig-Maximilian's University, Grosshadern, Munich, Germany
2 Department of Medicine, Ludwig-Maximilian's University, IS, Munich, Germany
3 Department of Virology, Ludwig-Maximilian's University, Munich, Germany

Correspondence: Correspondence and offprint requests to: Joachim Andrassy, Department of Surgery, Transplant Division, Marchioninistrasse 15, 81377 Munich, Germany. Tel: +49-89-70950; Fax: +49-89-7095-5674; E-mail: joachim.andrassy{at}med.uni-muenchen.de


  Abstract

Cytomegalovirus (CMV) infection after renal transplantation is a problem of increasing concern resulting in significant morbidity and mortality. Widespread use of ganciclovir (GCV) and valganciclovir (VGCV) may cause an increase of CMV resistance to these first line drugs. Other treatment options are sparse and often complicated by adverse events, namely nephrotoxicity associated with foscarnet and cidofovir. Leflunomide may be another treatment option for CMV infections. So far it is not clear if leflunomide can also be used in the case of GCV-resistant CMV infections. Here we describe the use of leflunomide in two patients after renal transplantation with GCV-resistant CMV infections.

Key Words: CMV • ganciclovir • leflunomide • renal transplantation

Received for publication January 3, 2009. Accepted for publication January 6, 2009.


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