Infect Chemother.
2024 Mar;56(1):101-121. 10.3947/ic.2024.0016.
Prevention of Cytomegalovirus Infection in Solid Organ Transplant Recipients: Guidelines by the Korean Society of Infectious Diseases and the Korean Society for Transplantation
- Huh K
1 - Lee SO2
- Kim J3
- Lee SJ4
- Choe PG5
- Kang JM6
- Yang J7
- Sung H8
- Kim SH9
- Moon C10
- Seok H11
- Shi HJ12
- Wi YM9
- Jeong SJ13
- Park WB5
- Kim YJ14
- Kim J15
- Ahn HJ16
- Kim NJ5
- Peck KR1
- Kim MS17
- Kim SI18
- Affiliations
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- 1Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 2Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 3Division of Infectious Diseases, Department of Medicine, Chungnam National University School of Medicine, Daejeon, Korea
- 4Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea
- 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- 6Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- 7Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
- 8Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 9Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
- 10Division of Infectious Diseases, Department of Internal Medicine, Inje University Busan Paik Hospital, College of Medicine, Busan, Korea
- 11Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University Medicine, Ansan, Korea
- 12Division of Infectious Diseases, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- 13Division of Infectious Diseases, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 14Division of Infectious Diseases, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
- 15Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 16Department of Surgery, College of Medicine, Kyung Hee University, Seoul, Korea
- 17Department of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
- 18Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- KMID: 2554988
- DOI: http://doi.org/10.3947/ic.2024.0016
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.
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