RESPIRATORY INFECTIONS 

Minerva Pneumologica 2009 June;48(2):165-75

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Cytomegalovirus infections in lung transplantation

Solidoro P. ¹, Libertucci D. ¹, Bardessono M. ¹, Braida A. ¹, Ruffini E. ², Costa C. ³

¹ Operative Unit of Pneumology University Hospital S. Giovanni Battista Turin, Italy 2 Operative Unit of Thoracic Surgery University Hospital S. Giovanni Battista Turin, Italy 3 Operative Unit of Virology University Hospital S. Giovanni Battista Turin, Italy

Among solid organ recipients lung transplantation recipients are at highest risk to be affected by cytomegalovirus infection (CMV) or to die from CMV disease. Furthermore acute and chronic lung rejection represents the most serious complication limiting long term survival for these patients. Despite advances in surgical techniques and immunosuppressive therapy to prevent allograft rejection, the clinical importance of CMV has grown in parallel with the increasing number of solid organ transplant recipients. The clinical symptoms related to CMV disease and the prevention of CMV infection show variation among different patient populations, depending on the type of transplant and the intensity of immunosuppression. In particular, in lung transplantation, CMV infection seems to be related to acute and chronic rejection leading to a self-manteining prone to the graft disfunction. Treatment and prevention of CMV infection have assumed increasing importance in care of transplant recipients relative to the availibility of effective antiviral agents as well as new diagnostic techniques and the prophylaxis, diagnosis, and treatment of CMV infections in lung transplant recipients is evolving with experience. Due to the high mortality rate associated with CMV disease in the transplantation setting, the optimal management strategy for the control of CMV infection is the prevention of overt disease. The two main approaches for prevention of CMV disease are antiviral prophylaxis and preemptive therapy using the currently available anti-CMV compounds. An overview of CMV infection following lung transplantation will be presented here.