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Cytomegalovirus in solid organ transplant recipients-Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice.
Clin Transplant. 2019 09; 33(9):e13512.CT

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.

Authors+Show Affiliations

Mayo Clinic, Rochester, Minnesota.University Health Network, Toronto, Ontario, Canada. Transplant Institute, University of Toronto, Toronto, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30817026

Citation

Razonable, Raymund R., and Atul Humar. "Cytomegalovirus in Solid Organ Transplant recipients-Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice." Clinical Transplantation, vol. 33, no. 9, 2019, pp. e13512.
Razonable RR, Humar A. Cytomegalovirus in solid organ transplant recipients-Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13512.
Razonable, R. R., & Humar, A. (2019). Cytomegalovirus in solid organ transplant recipients-Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice. Clinical Transplantation, 33(9), e13512. https://doi.org/10.1111/ctr.13512
Razonable RR, Humar A. Cytomegalovirus in Solid Organ Transplant recipients-Guidelines of the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13512. PubMed PMID: 30817026.
* Article titles in AMA citation format should be in sentence-case
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, Y1 - 2019/03/28/ PY - 2019/02/02/received PY - 2019/02/11/accepted PY - 2019/3/1/pubmed PY - 2020/10/2/medline PY - 2019/3/1/entrez KW - cidofovir KW - cytomegalovirus KW - foscarnet KW - transplantation KW - valganciclovir SP - e13512 EP - e13512 JF - Clinical transplantation JO - Clin Transplant VL - 33 IS - 9 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. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/30817026/Cytomegalovirus_in_solid_organ_transplant_recipients_Guidelines_of_the_American_Society_of_Transplantation_Infectious_Diseases_Community_of_Practice_ L2 - https://doi.org/10.1111/ctr.13512 DB - PRIME DP - Unbound Medicine ER -