The Prognostic Significance of Positive CMV Cultures During Surveillance of Renal Transplant Recipients

CMV: Prevention, Diagnosis and Therapy

“…Seropositive humans may shed CMV in their secretions, especially during times of stress, rendering positive cultures that do not necessarily reflect active disease. Viral culture of blood for CMV has poor sensitivity, while CMV urine, stool and sputum cultures have poor specificity (84). Culture of tissue specimens remains an important option for diagnosis of tissue invasive disease, particularly for gastrointestinal samples (i.e.…”

Management of cytomegalovirus infection after liver transplantation

“…Likewise, acute fulminant hepatitis, an additional independent risk factor for CMV disease after OLT, is associated with significant release of inflammatory cytokines. 21 Lastly, such situations as stress secondary to prolonged intra-abdominal surgery or bacterial infections, which are associated with increased levels of lipopolysaccharides, could explain their epidemiological association with an increased risk for CMV disease [22][23][24][25][26][27] (Table 1).…”

“…28 Steroids as monotherapy have a minimal effect on reactivation of latent CMV in vivo; however, when high doses are used, a greater incidence and increased severity of CMV disease has been observed, most likely by decreasing cellular immune function. 29 Mycophenolate mofetil has dramatically reduced the incidence of acute allograft rejection in renal transplant Rejection and antirejection therapy 5,11,22 Fulminant hepatic failure 22,26 Hepatic artery thrombosis 11 HHV-6 and HHV-7 infections 36,76 Hepatitis C infection 77 recipients, and this has been associated with an increase in the frequency and severity of CMV invasive disease. [30][31][32] Last, the conventional antilymphocyte preparations (OKT3 and antilymphocyte globulin, among others) not only increase CMV replication by suppressing the immune system, but most importantly, by directly reactivating latent CMV by means of the activation of transcription factors.…”

Longitudinal analysis of cytomegalovirus load in renal transplant recipients using a quantitative polymerase chain reaction: correlation with disease

“…On the basis of the differing patterns of HCMV infection and disease in particular patient groups (vide supra) we reasoned that such analysis should be performed on a single patient group. Since we have previously undertaken extensive prospective analyses of HCMV infection and disease in the renal transplant group (Grundy et al, , 1988Iragorri et al, 1993;Lui et al, 1987;Pillay et al, 1993), we have applied the quantitative PCR methodology to investigate fluctuations of viral load in the urine of these patients.…”