Related Experiment Video
Updated: Jul 7, 2026
13:19
Mouse Model for Pancreas Transplantation Using a Modified Cuff Technique
Published on: December 16, 2017
10.9K
CMV Viremia and Colitis in Simultaneous Pancreas-Kidney Transplantation
Simardeep Singh1, Aayushi J Rajani2, Shifa Karatela2
1Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.
The American Journal of Case Reports
|May 16, 2025
Summary
Managing resistant cytomegalovirus (CMV) infection in transplant patients is challenging. This case demonstrates a successful strategic switch between antivirals, including maribavir and letermovir, to overcome resistance and prevent severe complications.
Area of Science:
- Transplant Medicine
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) infection poses a significant threat to transplant recipients.
- Limited antiviral options and emerging resistance complicate CMV management.
- Standard care involves antivirals, PCR monitoring, resistance testing, and toxicity management.
Purpose of the Study:
- To highlight the challenges in managing CMV infection with antiviral resistance in a transplant patient.
- To illustrate a successful strategic therapeutic approach for resistant CMV.
- To emphasize the importance of vigilant monitoring and timely treatment adjustments.
Main Methods:
- Case report detailing the management of resistant CMV infection post-transplant.
- Sequential administration of ganciclovir, maribavir, foscarnet, and letermovir.
- Close monitoring of CMV PCR and viral load.
Main Results:
- Development of significant, resistant CMV viremia despite prophylaxis.
- Successful viral suppression achieved through sequential antiviral therapy.
- Minimization of drug toxicity through strategic treatment transitions.
Conclusions:
- Antiviral resistance in CMV infections presents a major therapeutic hurdle in transplant patients.
- A strategic, multi-drug approach, including maribavir and letermovir, can effectively manage resistant CMV.
- Vigilant monitoring and adaptive treatment strategies are crucial for successful outcomes and preventing mortality.
Related Concept Videos
01:29Chronic Pancreatitis II: Collaborative Care
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
01:28Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
01:27Cytomegalovirus Disease
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
01:21Chronic Pancreatitis II: Pathophysiology
Chronic pancreatitis is a progressive and irreversible inflammation of the pancreas, most often caused by long-term alcohol abuse, but it can also be related to ductal obstruction, smoking, or genetic factors.Chronic pancreatitis occurs when the pancreas is repeatedly exposed to harmful agents like alcohol, smoking, ductal obstruction, or genetic predisposition. These factors lead to the release of toxic metabolites and inflammatory cytokines, sustaining chronic inflammation in the pancreatic...