There was evidence of lower bioavailability in children younger than three years. Final model estimates of apparent oral clearance (L/h), apparent volume of distribution (L), and absorption rate constant were 7.33, 35.1, and 0.85, respectively. Ganciclovir plasma profiles were consistent with a one-compartment model. EBV DNA was quantified by TaqMan® polymerase chain reaction. Ganciclovir was measured by liquid chromatography/ultraviolet detection. Our objective was to characterize the pharmacokinetics of ganciclovir in the plasma of pediatric kidney and liver transplant patients taking valganciclovir for EBV prophylaxis. This approach is untested in clinical trials and valganciclovir dosing strategies in children are highly variable. Antiviral prophylaxis with valganciclovir is used frequently in pediatric solid organ transplant patients to prevent Epstein–Barr virus (EBV)-induced infections and tissue-invasive disease including post-transplant lymphoproliferative disorder (PTLD).
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