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Infection Prophylaxis after Acute Rejection Treatment
- It is suggested that oral nystatin mouthwash is used during the period of augmented corticosteroids (100,000 units qds).
- If pulse IV Methylprednisolone or ATG is given for late AR, co-trimoxazole should be given for 3 months.
- Valganciclovir should be given for 3-6 months if ATG is used, even if CMV serostatus is D-/R-. For pulse IV Methylprednisolone, it is suggested that a pre-emptive approach to CMV is employed for 6 months, involving checking for CMV PCR at clinic visits.