Infect Chemother.  2013 Sep;45(3):260-271. 10.3947/ic.2013.45.3.260.

Cytomegalovirus Infections in Solid Organ Transplantation: A Review

Affiliations
  • 1Division of Infectious Diseases, Department of Medicine and the William J von Liebig Transplant Center, Mayo Clinic, Rochester, Minnesota 55905, USA. razonable.raymund@mayo.edu

Abstract

Cytomegalovirus (CMV) continues to have a tremendous impact in solid organ transplantation despite remarkable advances in its diagnosis, prevention and treatment. It can affect allograft function and increase patient morbidity and mortality through a number of direct and indirect effects. Patients may develop asymptomatic viremia, CMV syndrome or tissue-invasive disease. Late-onset CMV disease continues to be a major problem in high-risk patients after completion of antiviral prophylaxis. Emerging data suggests that immunologic monitoring may be useful in predicting the risk of late onset CMV disease. There is now increasing interest in the development of an effective vaccine for prevention. Novel antiviral drugs with unique mechanisms of action and lesser toxicity are being developed. Viral load quantification is now undergoing standardization, and this will permit the generation of clinically relevant viral thresholds for the management of patients. This article provides a brief overview of the contemporary epidemiology, clinical presentation, diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients.

Keyword

Cytomegalovirus; Transplant; Diagnosis; Prevention; Treatment

MeSH Terms

Antiviral Agents
Cytomegalovirus
Cytomegalovirus Infections
Humans
Monitoring, Immunologic
Organ Transplantation
Transplantation, Homologous
Transplants
Viral Load
Viremia
Antiviral Agents

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