The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Effect of Towne Live Virus Vaccine on Cytomegalovirus Disease after Renal Transplant: A Controlled Trial

Stanley A. Plotkin, MD; Stuart E. Starr, MD; Harvey M. Friedman, MD; Kenneth Brayman, MD; Sandra Harris, MD; Stephanie Jackson; Nancy B. Tustin, MLT (ASCP), (HEW); Robert Grossman, MD; Donald Dafoe, MD; and Clyde Barker, MD
[+] Article, Author, and Disclosure Information

Grant Support: By grants NIH-FD-R-000267-03 and NIH-RO1-A125822-03 from the National Institutes of Health and grant FDA-OP-90-1 from the Food and Drug Administration.

Requests for Reprints: Stanley A. Plotkin, MD, Division of Infectious Diseases, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104.

Current Author Addresses: Drs. Plotkin and Starr and Ms. Jackson and Ms. Tustin: Division of Infectious Diseases, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104.

Dr. Friedman: University of Pennsylvania, Department of Infectious Diseases, 37th and Hamilton Walk, 535 Johnson Pavilion, Philadelphia, PA 19104.

Dr. Bray man: 365 Dakota Avenue South, Golden Valley, MN 54216.

Dr. Harris: Medical College of Pennsylvania, 3300 Henry Avenue, Philadelphia, PA 19129.

Dr. Grossman: Hospital of the University of Pennsylvania, Renal Electrolyte/Dialysis Unit, 210 White Building, 3400 Spruce Street, Philadelphia, PA 19104.

Drs. Dafoe and Barker: Hospital of the University of Pennsylvania, Department of Surgery, 4 Silverstein Pavilion, 3400 Spruce Street, Philadelphia, PA 19104.

©1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;114(7):525-531. doi:10.7326/0003-4819-114-7-525
Text Size: A A A

Objective: To test the efficacy of vaccination with the Towne live attenuated cytomegalovirus vaccine.

Design: A double-blind, randomized, placebo-controlled trial in candidates for renal transplantation. The cytomegalovirus serologic status of both recipients and donors was determined, and the recipients were followed for periods of 6 months to 7 years after transplant.

Setting: A university transplant center.

Patients: The analyses were made on 237 patients who were given either vaccine or placebo, received renal transplants, and were followed for at least 6 months.

Intervention: Subcutaneous inoculation with Towne live attenuated virus or with placebo.

Main Outcome Measures: The presence of cytomegalovirus infection was defined by virus isolation and antibody tests. If infection occurred, a prearranged scoring system for cytomegalovirus disease was used to objectify disease severity.

Results: The vaccine was well tolerated, and there were no discernible long-term adverse effects. Recipients who were originally seropositive did not clearly benefit from vaccination. Protective efficacy was analyzed in the group at highest risk for cytomegalovirus disease: recipients who were seronegative at the time of vaccination and who received a kidney from a seropositive donor. Compared with placebo recipients, vaccinated patients in this group had significantly less severe cytomegalovirus disease, with a significant reduction in disease scores (P = 0.03) and 85% decrease in the most severe disease (95% CI, 35% to 96%), although infection rates were similar. Graft survival at 36 months was improved in vaccinated recipients of cadaver kidneys (8 of 16) compared with unvaccinated recipients (4 of 16) (P = 0.04).

Conclusions: Previous vaccination of seronegative renal transplant recipients with live cytomegalovirus results in reduction of disease severity mimicking the action of naturally derived immunity.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Journal Club
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.