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Updated: Aug 13, 2026
Expanding Cytotoxic T Lymphocytes from Umbilical Cord Blood that Target Cytomegalovirus, Epstein-Barr Virus, and Adenovirus
Published on: May 7, 2012
Cytomegalovirus infection in solid organ transplant recipients: new challenges and their implications for preventive
1VA Medical Center and University of Pittsburgh, Infectious Disease Section, University Drive C, Pittsburgh, PA 15240, USA. nis5+@pitt.edu
Background:
Late-onset CMV disease is being increasingly recognized as a significant post-transplantation complication.
Objectives:
To discern the impact of antiviral prophylactic strategies on the emerging syndrome of late-onset CMV disease in organ transplant recipients.
Study Design:
Review of existing reports and published data relevant to antiviral prophylaxis in organ transplant recipients.
Results:
Prevention of CMV using prophylaxis has proven effective and is widely employed in organ transplant recipients. However, late-onset CMV disease is increasingly being recognized as a significant complication in these patients. The more potent the activity of the antiviral drug and the longer duration of prophylaxis, the greater likelihood of late-onset CMV disease. CMV seronegative recipients of seropositive donor allografts appear to be at a uniquely high risk. A higher proportion of patients with late-onset CMV have tissue invasive disease. Late-onset CMV disease in liver transplant recipients conferred an independently higher risk of mortality in the first post-transplant year. Prolonged antiviral therapy may impair the recovery of CMV-specific T-cell responses. Preemptive therapy appears to be less likely to be associated with CMV disease.
Conclusions:
Discernment of the pathophysiologic basis of late-onset CMV warrants investigation. Preemptive therapy may be the preferable approach to CMV prophylaxis.
Insights
Late-onset cytomegalovirus (CMV) disease is a growing concern in organ transplant recipients. Preemptive therapy may offer a better approach to preventing CMV compared to traditional prophylaxis.
Area of Science:
- Transplantation Medicine
- Infectious Diseases
- Immunology
Background:
- Late-onset cytomegalovirus (CMV) disease is an emerging complication following organ transplantation.
- Understanding risk factors and prevention strategies is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the effectiveness of antiviral prophylactic strategies in preventing late-onset CMV disease in organ transplant recipients.
- To identify patient populations at higher risk for this complication.
Main Methods:
- A comprehensive review of published literature and existing data on antiviral prophylaxis in organ transplant recipients.
- Analysis of factors influencing the incidence and outcomes of late-onset CMV disease.
Main Results:
- Antiviral prophylaxis is effective but can be associated with an increased risk of late-onset CMV disease, especially with potent drugs and prolonged use.
- CMV-seronegative recipients of seropositive donor allografts are at particularly high risk.
- Late-onset CMV disease, especially in liver transplant recipients, is linked to higher mortality and invasive tissue disease.
- Prolonged antiviral therapy may hinder CMV-specific T-cell recovery.
Conclusions:
- Preemptive therapy may be a more favorable strategy for CMV prophylaxis in organ transplant recipients.
- Further research into the pathophysiology of late-onset CMV disease is warranted.
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