Prevention of Cytomegalovirus Infection in Solid Organ Transplant Recipients:Guidelines by the Korean Society of Infectious Diseases and the Korean Society for Transplantation
- Author:
Kyungmin HUH
1
;
Sang-Oh LEE
;
Jungok KIM
;
Su Jin LEE
;
Pyoeng Gyun CHOE
;
Ji-Man KANG
;
Jaeseok YANG
;
Heungsup SUNG
;
Si-Ho KIM
;
Chisook MOON
;
Hyeri SEOK
;
Hye Jin SHI
;
Yu Mi WI
;
Su Jin JEONG
;
Wan Beom PARK
;
Youn Jeong KIM
;
Jongman KIM
;
Hyung Joon AHN
;
Nam Joong KIM
;
Kyong Ran PECK
;
Myoung Soo KIM
;
Sang Il KIM
Author Information
- Publication Type:Special Article
- From:Infection and Chemotherapy 2024;56(1):101-121
- CountryRepublic of Korea
- Language:EN
- Abstract: Cytomegalovirus (CMV) is the most important opportunistic viral pathogen in solid organ transplant (SOT) recipients.The Korean guideline for the prevention of CMV infection in SOT recipients was developed jointly by the Korean Society for Infectious Diseases and the Korean Society of Transplantation. CMV serostatus of both donors and recipients should be screened before transplantation to best assess the risk of CMV infection after SOT. Seronegative recipients receiving organs from seropositive donors face the highest risk, followed by seropositive recipients. Either antiviral prophylaxis or preemptive therapy can be used to prevent CMV infection. While both strategies have been demonstrated to prevent CMV infection post-transplant, each has its own advantages and disadvantages. CMV serostatus, transplant organ, other risk factors, and practical issues should be considered for the selection of preventive measures. There is no universal viral load threshold to guide treatment in preemptive therapy. Each institution should define and validate its own threshold.Valganciclovir is the favored agent for both prophylaxis and preemptive therapy. The evaluation of CMV-specific cellmediated immunity and the monitoring of viral load kinetics are gaining interest, but there was insufficient evidence to issue recommendations. Specific considerations on pediatric transplant recipients are included.
