Ganciclovir-resistant cytomegalovirus in organ transplant recipients.
Ganciclovir-resistant (GanR) cytomegalovirus (CMV) is an emerging clinical problem in organ transplant recipients, particularly recipients of kidney and pancreas and lung transplants. GanR CMV, a late posttransplantation complication, is observed predominantly among CMV-seronegative recipients of organs from seropositive donors, especially among recipients receiving intensive immunosuppression and having prolonged exposure to ganciclovir. Given the limitations of current diagnostic methods, if GanR CMV is clinically suspected, empirical treatment with intravenously administered foscarnet should be used in conjunction with reductions in immunosuppressive therapy and possibly CMV hyperimmune globulin. Better diagnostic tools and newer, less-toxic antiviral agents with different mechanisms of action are urgently needed to decrease the morbidity associated with this complication in organ transplant recipients.
Limaye
Ajit P
AP
Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA 98195-7110 , USA. limaye@u.washington.edu
D000998:Antiviral Agents / Q000494:pharmacology*; D003587:Cytomegalovirus / Q000187:drug effects*; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000473:pathology; D004352:Drug Resistance, Microbial / Q000502:physiology*; D015774:Ganciclovir / Q000494:pharmacology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors
D000998:Antiviral Agents; D015774:Ganciclovir