CMV Immunoglobulins for the Treatment of CMV Infections in Thoracic Transplant Recipients

Transplantation
Uwe SchulzFrank Enseleit

Abstract

Intravenous ganciclovir and, increasingly, oral valganciclovir are now considered the mainstay of treatment for cytomegalovirus (CMV) infection or CMV disease. Under certain circumstances, CMV immunoglobulin (CMVIG) may be an appropriate addition or, indeed, alternative. Data on monotherapy with CMVIG are limited, but encouraging, for example in cases of ganciclovir intolerance. In cases of recurrent CMV in thoracic transplant patients after a disease- and drug-free period, adjunctive CMVIG can be considered in patients with hypogammaglobulinemia. Antiviral-resistant CMV, which is more common among thoracic organ recipients than in other types of transplant, can be an indication for introduction of CMVIG, particularly in view of the toxicity associated with other options, such as foscarnet. Due to a lack of controlled trials, decision-making is based on clinical experience. In the absence of a robust evidence base, it seems reasonable to consider the use of CMVIG to treat CMV in adult or pediatric thoracic transplant patients with ganciclovir-resistant infection, or in serious or complicated cases. The latter can potentially include (i) treatment of severe clinical manifestations, such as pneumonitis or eye complications; (ii) ...Continue Reading

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Jun 25, 2016·Expert Opinion on Pharmacotherapy·Luciano PotenaLaura Borgese
Feb 7, 2017·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Zsuzsanna KovatsVeronika Müller
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Methods Mentioned

BETA
PCR
bronchoalveolar lavage
genotyping
biopsy
biopsies

Software Mentioned

VICTOR

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