AUTHOR=Grossi Paolo Antonio , Kamar Nassim , Saliba Faouzi , Baldanti Fausto , Aguado Jose M. , Gottlieb Jens , Banas Bernhard , Potena Luciano 

TITLE=Cytomegalovirus Management in Solid Organ Transplant Recipients: A Pre-COVID-19 Survey From the Working Group of the European Society for Organ Transplantation

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10332

DOI=10.3389/ti.2022.10332

ISSN=1432-2277

ABSTRACT=Infectious complications are a leading cause of morbidity/mortality after solid organ transplantation (SOT), and cytomegalovirus (CMV) is a very important pathogen that remains a considerable threat to SOT success. A survey was conducted between 19 July and 31 October 2019 to understand clinical practices for preventing and managing CMV infections and disease in SOT recipients. The survey also sought to identify how practices aligned with guidelines, how adequately treatments met patients’ needs, and what respondents’ expectations for future developments were. This cross-sectional study involved transplant professionals who completed a 30–40-minute online questionnaire. Overall, 224 responses were included in the analysis; 160 hospitals and 197 different SOT programs were represented across 41 countries; 167 (83%) were European. Findings revealed a heterogenous approach to CMV diagnosis and management in SOT and, sometimes, divergence from international guidelines. Antiviral prophylaxis with valganciclovir was administered by 201/224 (90%) respondents in D+/R− transplantations, across SOT types. Virological monitoring and pre-emptive antiviral therapy (PET) were generally reserved for R+ cases, with DNA threshold to initiate treatment ranging across three logs of DNA copies/ml (10–10,000 copies/ml). Ganciclovir-resistant CMV strains were still perceived as one of the major challenges, and tailored treatment was identified as one of the most important unmet needs for CMV management. Results of this survey may help to design future studies aimed at evaluating the safety and efficacy of new strategies to prevent CMV disease in SOT recipients, and could also help to harmonize management approaches for CMV in this challenging population.