Slaying the “Troll of Transplantation”—new frontiers in cytomegalovirus management: A report from the CMV International Symposium 2023

Kotton, Camille N.; Torre‐Cisneros, Julian; Yakoub‐Agha, Ibrahim; ,

doi:10.1111/tid.14183

Cited by 3 publications

(2 citation statements)

References 121 publications

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“…CMV prophylaxis refers to the use of antivirals in all patients at increased risk of CMV reactivation, whereas preemptive therapy refers to the administration of antivirals only with evidence of CMV replication. The optimal approach to the prevention and treatment of infection due to CMV remains uncertain despite years of experience with antiviral therapies, due to the dynamic immune status specific to CMV [ 1 , 3 , 33 ]. A recent worldwide survey on CMV prevention strategies in SOT found that universal prophylaxis was used in 90% of centers in D+/R− and in 50% in of R+ SOT with variable duration depending on the type of transplant, CMV serostatus, and induction immunosuppression [ 4 ▪▪ ].…”

Section: Prophylaxis Versus Pre-emptive Treatmentmentioning

confidence: 99%

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Recent advances in cytomegalovirus infection management in solid organ transplant recipients

Grossi,

Peghin

2024

Current Opinion in Organ Transplantation

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Purpose of review Human cytomegalovirus (CMV) continues to be the most important infectious complication following solid organ transplantation (SOT). Recent findings Universal prophylaxis and preemptive therapy are the most adopted strategies for prevention of CMV disease globally. Prophylaxis with valganciclovir is the most widely used approach to CMV prevention, however leukopenia and late onset CMV disease after discontinuation of prophylaxis requires new strategies to prevent this complication. The use of assays detecting CMV-specific T cell-mediated immunity may individualize the duration of antiviral prophylaxis after transplantation. Letermovir has been recently approved for prophylaxis in kidney transplant recipients. CMV-RNAemia used together with CMV-DNAemia in the viral surveillance of CMV infection provides accurate information on viral load kinetics, mostly in patients receiving letermovir prophylaxis/therapy. The development of refractory and resistant CMV infection remains a major challenge and a new treatment with maribavir is currently available. In the present paper we will review the most recent advances in prevention and treatment of CMV diseases in SOT recipients. Summary Recent findings, summarized in the present paper, may be useful to optimize prevention and treatment of CMV infection in SOT.

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Section: Prophylaxis Versus Pre-emptive Treatmentmentioning

confidence: 99%

“…Moreover, it may increase the cost of transplantation, and negatively impact SOT quality of life [ 1 , 2 ▪▪ ]. However, there are still several unmet needs in CMV management in posttransplant settings [ 3 ]. In the present paper we will review the most recent advances in prevention and treatment of CMV diseases in SOT recipients.…”

Section: Introductionmentioning

confidence: 99%

Recent advances in cytomegalovirus infection management in solid organ transplant recipients

Grossi,

Peghin

2024

Current Opinion in Organ Transplantation

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Refractory/Resistant Cytomegalovirus Infection in Transplant Recipients: An Update

Royston,

Papanicolaou,

Neofytos

2024

Viruses

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Despite the significant progress made, CMV infection is one of the most frequent infectious complications in transplant recipients. CMV infections that become refractory or resistant (R/R) to the available antiviral drugs constitute a clinical challenge and are associated with increased morbidity and mortality. Novel anti-CMV therapies have been recently developed and introduced in clinical practice, which may improve the treatment of these infections. In this review, we summarize the treatment options for R/R CMV infections in adult hematopoietic cell transplant and solid organ transplant recipients, with a special focus on newly available antiviral agents with anti-CMV activity, including maribavir and letermovir.

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Management of cytomegalovirus infection after liver transplantation

Yilmaz,

Memisoglu,

Akbulut

2024

World J Transplant

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Cytomegalovirus (CMV) infection is one of the primary causes of morbidity and mortality following liver transplantation (LT). Based on current worldwide guidelines, the most effective strategies for avoiding post-transplant CMV infection are antiviral prophylaxis and pre-emptive treatment. CMV- IgG serology is the established technique for pretransplant screening of both donors and recipients. The clinical presentation of CMV infection and disease exhibits variability, prompting clinicians to consistently consider this possibility, particularly within the first year post-transplantation or subsequent to heightened immunosuppression. At annual symposia to discuss CMV prevention and how treatment outcomes can be improved, evidence on the incorporation of immune functional tests into clinical practice is presented, and the results of studies with new antiviral treatments are evaluated. Although there are ongoing studies on the use of letermovir and maribavir in solid organ transplantation, a consensus reflected in the guidelines has not been formed. Determining the most appropriate strategy at the individual level appears to be the key to enhancing outcomes. Although prevention strategies reduce the risk of CMV disease, the disease can still occur in up to 50% of high-risk patients. A balance between the risk of infection and disease development and the use of immunosuppressants must be considered when talking about the proper management of CMV in solid organ transplant recipients. The objective of this study was to establish a comprehensive framework for the management of CMV in patients who have had LT.

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Slaying the “Troll of Transplantation”—new frontiers in cytomegalovirus management: A report from the CMV International Symposium 2023

Cited by 3 publications

References 121 publications

Recent advances in cytomegalovirus infection management in solid organ transplant recipients

Recent advances in cytomegalovirus infection management in solid organ transplant recipients

Refractory/Resistant Cytomegalovirus Infection in Transplant Recipients: An Update

Management of cytomegalovirus infection after liver transplantation

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