Ganciclovir for Cytomegalovirus after Heart Transplantation

To the Editor: Although the study by Merigan et al. (April 30 issue) 1 demonstrated that the use of ganciclovir as prophylaxis for cytomegalovirus (CMV) infection in heart-transplant recipients was associated with fewer cases of CMV disease than was placebo, the clinical importance of this benefit is unclear. The definition of CMV syndrome, for example, may have included cases of very mild illness. Furthermore, the patients at highest risk for serious disease (i.e., CMV-seronegative recipients of organs from CMV-seropositive donors) received no benefit from the described course of prophylaxis. We found no benefit from an early, brief course of ganciclovir in . . .