CMV infection management in transplant patients in Italy

Grossi, Paolo; Baldanti, Fausto; Andreoni, Massimo; Perno, Carlo Federico

doi:10.1016/j.jcv.2019.104211

Cited by 10 publications

(14 citation statements)

References 70 publications

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“…Viral load variability among assays calibrated by the WHO international standard occurred due to differences in the assay platform, gene targets, and amplicon size [ 36 , 37 ]. Therefore, the same assay platform should be used for serial CMV surveillance and monitoring using the same type of sample [ 27 , 38 , 39 ]. It is recommended that transplant centers work with their laboratories to define and validate center-specific viral load thresholds for each clinical application [ 2 , 40 ].…”

Section: Assays Of Virus Detectionmentioning

confidence: 99%

Laboratory diagnostic testing for cytomegalovirus infection in solid organ transplant patients

Lee

2022

Korean J Transplant

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Human cytomegalovirus (CMV) infection, which is one of the most common complications in transplant recipients, increases the risk of graft loss and rejection. Laboratory strategies for diagnosing CMV infection rely on the measurement of viral DNAemia and CMV-specific cell-mediated immunity (CMV-CMI). The CMV quantitative nucleic acid amplification test (QNAT) enabled the spread of preemptive therapy and prompted recommendations for surveillance, diagnosis, and monitoring. Despite the implementation of the World Health Organization international standard for calibration, variability of QNAT persists due to technical issues. CMV immunoglobulin G serology is the standard method for CMV immune screening of transplant candidates and donors. Assays for CMV-CMI play an important role in helping to predict the risk and to develop an individualized CMV management plan. Genotypic testing for resistance is needed when drug-resistant CMV infection is suspected. Here, we review the state of the art of laboratory tests for CMV infection in solid organ transplantation.

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Section: Assays Of Virus Detectionmentioning

confidence: 99%

Laboratory diagnostic testing for cytomegalovirus infection in solid organ transplant patients

Lee

2022

Korean J Transplant

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“…Pre-transplant CMV immunoglobulin (Ig)G serological testing is generally undertaken in both donor and recipient to establish CMV disease risk and guide infection prevention strategies (5)(6)(7)(8)(9). CMVseronegative recipients who receive organs from CMV-seropositive donors (D+/R−) are at highest risk of disease since they lack the ability to mount an effective and timely immune response, because of pharmacological immunosuppression post-transplantation (10).…”

Section: Introductionmentioning

confidence: 99%

“…Regular post-transplant monitoring of viral replication helps to predict CMV disease risk and guide decisions relating to treatment duration and efficacy (8,9,(16)(17)(18). Monitoring was traditionally undertaken with the pp65 antigenemia assay and qualitative polymerase chain reaction (PCR) (7,19), but there has been a shift toward molecular methods such as quantitative nucleic acid testing. In addition, monitoring CMV-specific T cell immunity post-transplantation is an emerging tool for predicting and controlling CMV infection, and for guiding tailored prevention strategies (8,9,16,20).…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus Management in Solid Organ Transplant Recipients: A Pre-COVID-19 Survey From the Working Group of the European Society for Organ Transplantation

et al. 2022

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Infections are leading causes of morbidity/mortality following solid organ transplantation (SOT) and cytomegalovirus (CMV) is among the most frequent pathogens, causing a considerable threat to SOT recipients. A survey was conducted 19 July–31 October 2019 to capture clinical practices about CMV in SOT recipients (e.g., how practices aligned with guidelines, how adequately treatments met patients’ needs, and respondents’ expectations for future developments). Transplant professionals completed a ∼30-minute online questionnaire: 224 responses were included, representing 160 hospitals and 197 SOT programs (41 countries; 167[83%] European programs). Findings revealed a heterogenous approach to CMV diagnosis and management and, sometimes, significant divergence from international guidelines. Valganciclovir prophylaxis (of variable duration) was administered by 201/224 (90%) respondents in D+/R− SOT and by 40% in R+ cases, with pre-emptive strategies generally reserved for R+ cases: DNA thresholds to initiate treatment ranged across 10–10,000 copies/ml. Ganciclovir-resistant CMV strains were still perceived as major challenges, and tailored treatment was one of the most important unmet needs for CMV management. These findings may help to design studies to evaluate safety and efficacy of new strategies to prevent CMV disease in SOT recipients, and target specific educational activities to harmonize CMV management in this challenging population.

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“…There are no other reported cases of spontaneous CB owing to infectious etiologies in transplant or immunosuppressed patients. Given that CMV causes active infections in at least one-third of transplant recipients 24 and the high mortality of CB, this case highlights the need for additional investigation into the strength of the association between CMV and carotid pathology including CB.…”

Section: Discussionmentioning

confidence: 95%

Spontaneous carotid blowout of the common carotid artery in a chronically immunosuppressed transplant patient

Hakimi

Stuart²,

Zarkowsky³

et al. 2022

Journal of Vascular Surgery Cases, Innovations and Techniques

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CMV infection management in transplant patients in Italy

Cited by 10 publications

References 70 publications

Laboratory diagnostic testing for cytomegalovirus infection in solid organ transplant patients

Laboratory diagnostic testing for cytomegalovirus infection in solid organ transplant patients

Cytomegalovirus Management in Solid Organ Transplant Recipients: A Pre-COVID-19 Survey From the Working Group of the European Society for Organ Transplantation

Spontaneous carotid blowout of the common carotid artery in a chronically immunosuppressed transplant patient

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