The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation

TLDR

CMV infections remain a frequent complication in solid‑organ transplant recipients, increasing risks of graft loss, morbidity, and mortality, and prior consensus guidelines have helped standardize management. An international multidisciplinary panel expanded and revised evidence‑based consensus guidelines covering prevention, treatment, diagnostics, immunology, drug resistance, and pediatric issues. The updated guidelines highlight advances in molecular and immunologic diagnostics, refined thresholds, optimized prevention, novel antiviral and immunosuppressive therapies, and improved strategies for treatment‑resistant disease.

Abstract

Despite recent advances, cytomegalovirus (CMV) infections remain one of the most common complications affecting solid organ transplant recipients, conveying higher risks of complications, graft loss, morbidity, and mortality. Research in the field and development of prior consensus guidelines supported by The Transplantation Society has allowed a more standardized approach to CMV management. An international multidisciplinary panel of experts was convened to expand and revise evidence and expert opinion-based consensus guidelines on CMV management including prevention, treatment, diagnostics, immunology, drug resistance, and pediatric issues. Highlights include advances in molecular and immunologic diagnostics, improved understanding of diagnostic thresholds, optimized methods of prevention, advances in the use of novel antiviral therapies and certain immunosuppressive agents, and more savvy approaches to treatment resistant/refractory disease. The following report summarizes the updated recommendations.