MEETING REPORT
Transpl. Int.
Advancements in cytomegalovirus (CMV) management among solid organ transplant recipients: insights from the ESOT CMV workshop 2023 Cytomegalovirus management: ESOT workshop 2023
- LT
Luca Toti 1
- NK
Nassim KAMAR 2
- SA
Sophie Alain 3
- OM
Oriol Manuel 4
- NB
Nikolina Basic-Jukic 5
- PA
PAOLO ANTONIO GROSSI 6
- HK
Hannah Kaminski 7
- PS
Paolo Solidoro 8
- LP
Luciano Potena 9
1. Department of Surgical Sciences, University of Rome Tor Vergata, Rome, Italy, Sicily
2. Department of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, INFINITY-Inserm U1291-CNRS U5051, University Paul Sabatier, Toulouse, France
3. Department of Virology and National Reference Center for Herpesviruses, Limoges University Hospital, UMR Inserm 1092, University of Limoges and University Hospital Federation SUPORT, Limoges, France
4. Infectious Diseases Service and Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland
5. Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
6. Università degli Studi dell'Insubria - ASST SetteLaghi, Varese, Italy
7. Department of Nephrology, Transplantation, Dialysis and Apheresis, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
8. S.C.U Pneumologia, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Department of Medical Sciences, University of Turin, Turin, Italy
9. Unit for Heart Failure and Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Abstract
Cytomegalovirus (CMV) infection poses significant challenges in solid organ transplant (SOT) recipients, impacting graft outcomes, morbidity, and in some cases survival. The ESOT CMV Workshop 2023 convened European experts to discuss current practices and advances in the management of CMV with the aim of improving the quality of life of transplant recipients. Discussions covered crucial areas such as preventive strategies, diagnostic challenges, therapeutic approaches, and the role of cell-mediated immunity (CMI) monitoring. Despite advances, ambiguity persists in optimal CMV management across European transplant centers. Preventive strategies, including universal prophylaxis and pre-emptive therapy, are effective but consensus is lacking with respect to the preferred approach. Diagnostic challenges such as standardization of viral load thresholds and detection of end-organ disease complicate timely intervention. While newer therapies like maribavir hold promise for treating complicated CMV infections, sustaining viral clearance remains a challenge. Integrating CMI monitoring into CMV management could personalize treatment decisions but has limitations in in terms of predictive value and accessibility. Further research is needed to fill these gaps and optimize CMV management. The collaborative efforts, led by the European Society for Organ Transplantation (ESOT), aim to standardize and improve CMV care, ensuring better outcomes for SOT recipients.
Summary
Keywords
cytomegalovirus, Solid Organ Transplant Recipients, universal prophylaxis, pre-emptive therapy, cell-mediated immunity
Received
11 December 2024
Accepted
21 July 2025
Copyright
© 2025 Toti, KAMAR, Alain, Manuel, Basic-Jukic, GROSSI, Kaminski, Solidoro and Potena. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Luciano Potena, luciano.potena2@unibo.it
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