Impact of cytomegalovirus infection on organ transplant recipients.
Cytomegalovirus (CMV) is the single most important infectious agent affecting recipients of organ transplants, with at least two-thirds of these patients having CMV infection 1-4 months after transplantation. Latently infected allografts are the major exogenous source of CMV infection in transplant recipients, although leukocyte-containing blood products can also transmit the virus. Three patterns of CMV infection are recognized: primary infection, reactivation infection, and superinfection. Primary infection has the greatest clinical impact. The clinical effects of CMV infection include infectious disease syndromes such as pneumonia and chorioretinitis; an immunosuppressed state that predisposes to potentially lethal opportunistic infection; and the initiation of a process that can result in allograft injury. Progress has been made in controlling CMV infection; hyperimmune anti-CMV globulin and certain antiviral drugs appear promising for prophylaxis, and the combination of hyperimmunoglobulin and ganciclovir appears promising for therapy.
Rubin
R H
RH
Infectious Disease Unit, Massachusetts General Hospital, Boston 02114.
D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D009894:Opportunistic Infections / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D015163:Superinfection / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D014180:Transplantation