Cytomegalovirus in solid organ transplant recipients—Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Cytomegalovirus (CMV) is one of the most common opportunistic infections that affect the outcome of solid organ transplantation. This updated guideline from the American Society of Transplantation Infectious Diseases Community of Practice provides evidence-based and expert recommendations for screening, diagnosis, prevention, and treatment of CMV in solid organ transplant recipients. CMV serology to detect immunoglobulin G remains as the standard method for pretransplant screening of donors and transplant candidates. Antiviral prophylaxis and preemptive therapy are the mainstays of CMV prevention. The lack of a widely applicable viral load threshold for diagnosis and preemptive therapy is highlighted, as a result of variability of CMV nucleic acid testing, even in the contemporary era when calibrators are standardized. Valganciclovir and intravenous ganciclovir remain as drugs of choice for CMV management. Strategies for managing drug-resistant CMV infection are presented. There is an increasing use of CMV-specific cell-mediated immune assays to stratify the risk of CMV infection after solid organ transplantation, but their role in optimizing CMV prevention and treatment efforts has yet to be demonstrated. Specific issues related to pediatric transplant recipients are discussed.

Original languageEnglish (US)
Article numbere13512
JournalClinical Transplantation
DOIs
StatePublished - Jan 1 2019

Fingerprint

Cytomegalovirus
Communicable Diseases
Transplants
Cytomegalovirus Infections
Organ Transplantation
Donor Selection
Ganciclovir
Evidence-Based Practice
Opportunistic Infections
Serology
Therapeutics
Viral Load
Pharmaceutical Preparations
Nucleic Acids
Antiviral Agents
Immunoglobulin G
Tissue Donors
Guidelines
Pediatrics

Keywords

  • cidofovir
  • cytomegalovirus
  • foscarnet
  • transplantation
  • valganciclovir

ASJC Scopus subject areas

  • Transplantation

Cite this

@article{badd3b6c2d67428883f5221db4a8dac1,
title = "Cytomegalovirus in solid organ transplant recipients—Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice",
abstract = "Cytomegalovirus (CMV) is one of the most common opportunistic infections that affect the outcome of solid organ transplantation. This updated guideline from the American Society of Transplantation Infectious Diseases Community of Practice provides evidence-based and expert recommendations for screening, diagnosis, prevention, and treatment of CMV in solid organ transplant recipients. CMV serology to detect immunoglobulin G remains as the standard method for pretransplant screening of donors and transplant candidates. Antiviral prophylaxis and preemptive therapy are the mainstays of CMV prevention. The lack of a widely applicable viral load threshold for diagnosis and preemptive therapy is highlighted, as a result of variability of CMV nucleic acid testing, even in the contemporary era when calibrators are standardized. Valganciclovir and intravenous ganciclovir remain as drugs of choice for CMV management. Strategies for managing drug-resistant CMV infection are presented. There is an increasing use of CMV-specific cell-mediated immune assays to stratify the risk of CMV infection after solid organ transplantation, but their role in optimizing CMV prevention and treatment efforts has yet to be demonstrated. Specific issues related to pediatric transplant recipients are discussed.",
keywords = "cidofovir, cytomegalovirus, foscarnet, transplantation, valganciclovir",
author = "Razonable, {Raymund R} and Atul Humar",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/ctr.13512",
language = "English (US)",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Cytomegalovirus in solid organ transplant recipients—Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice

AU - Razonable, Raymund R

AU - Humar, Atul

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Cytomegalovirus (CMV) is one of the most common opportunistic infections that affect the outcome of solid organ transplantation. This updated guideline from the American Society of Transplantation Infectious Diseases Community of Practice provides evidence-based and expert recommendations for screening, diagnosis, prevention, and treatment of CMV in solid organ transplant recipients. CMV serology to detect immunoglobulin G remains as the standard method for pretransplant screening of donors and transplant candidates. Antiviral prophylaxis and preemptive therapy are the mainstays of CMV prevention. The lack of a widely applicable viral load threshold for diagnosis and preemptive therapy is highlighted, as a result of variability of CMV nucleic acid testing, even in the contemporary era when calibrators are standardized. Valganciclovir and intravenous ganciclovir remain as drugs of choice for CMV management. Strategies for managing drug-resistant CMV infection are presented. There is an increasing use of CMV-specific cell-mediated immune assays to stratify the risk of CMV infection after solid organ transplantation, but their role in optimizing CMV prevention and treatment efforts has yet to be demonstrated. Specific issues related to pediatric transplant recipients are discussed.

AB - Cytomegalovirus (CMV) is one of the most common opportunistic infections that affect the outcome of solid organ transplantation. This updated guideline from the American Society of Transplantation Infectious Diseases Community of Practice provides evidence-based and expert recommendations for screening, diagnosis, prevention, and treatment of CMV in solid organ transplant recipients. CMV serology to detect immunoglobulin G remains as the standard method for pretransplant screening of donors and transplant candidates. Antiviral prophylaxis and preemptive therapy are the mainstays of CMV prevention. The lack of a widely applicable viral load threshold for diagnosis and preemptive therapy is highlighted, as a result of variability of CMV nucleic acid testing, even in the contemporary era when calibrators are standardized. Valganciclovir and intravenous ganciclovir remain as drugs of choice for CMV management. Strategies for managing drug-resistant CMV infection are presented. There is an increasing use of CMV-specific cell-mediated immune assays to stratify the risk of CMV infection after solid organ transplantation, but their role in optimizing CMV prevention and treatment efforts has yet to be demonstrated. Specific issues related to pediatric transplant recipients are discussed.

KW - cidofovir

KW - cytomegalovirus

KW - foscarnet

KW - transplantation

KW - valganciclovir

UR - http://www.scopus.com/inward/record.url?scp=85063636885&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063636885&partnerID=8YFLogxK

U2 - 10.1111/ctr.13512

DO - 10.1111/ctr.13512

M3 - Article

C2 - 30817026

AN - SCOPUS:85063636885

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

M1 - e13512

ER -