Cytomegalovirus is the classic opportunistic infection after solid organ transplantation. This review
will discuss updates and future directions in the diagnosis, prevention and treatment of CMV infection in solid
organ transplant recipients. Antiviral prophylaxis and pre-emptive therapy are the mainstays of CMV prevention,
but they should not be mutually exclusive and each strategy should be considered depending on a specific situation.
The lack of a widely applicable viral load threshold for diagnosis and preemptive therapy is emphasized as a
major factor that should pave the way for an individualized approach to prevention. Valganciclovir and intravenous
ganciclovir remain as drugs of choice for CMV management, and strategies for managing drug-resistant
CMV infection are enumerated. There is increasing use of CMV-specific cell-mediated immune assays to stratify
the risk of CMV infection after solid organ transplantation, and their potential role in optimizing CMV prevention
and treatment efforts is discussed.
BK polyoma virus infection and renal disease in non-renal solid organ transplantation