In solid organ transplant recipients2 

CMV Seroprevalence is high in the general population and extends to one-half of high-risk solid organ transplant (SOT) recipients3

75%
More Than 50%
Up to 50%

In solid organ transplantation (SOT), the risk varies based on whether the organ donor is CMV-seropositive (D+) or CMV-seronegative (D−) and whether the organ recipient is CMV-seropositive (R+) or CMV-seronegative (R−).4

D, donor; R, recipient; +, CMV-seropositive; –, CMV-seronegative.  

CMV +/– Serostatus Is Independently Associated With Worse Allograft and Patient Survival in SOT8

In a large study (N=22,461) of SOT patients separated according to seroprevalence status, 10 years after transplantation, the 73.6% survival rate (95% CI, 72.3, 74.9) for the D–/R– group was significantly higher (P<0.0001) than all the other groups combined (66.1% [65.3, 66.9])8

D, donor; R, recipient; +, CMV-seropositive; –, CMV-seronegative.  

STUDY DESIGN: From the UK Transplant Registry, Desai and colleagues identified all recipients of kidney, liver, heart, and lung transplants in the United Kingdom between 1987 and 2007 with known CMV immunoglobulin G status. Recipients were classified according to donor (D) and recipient (R) serostatus: high-risk (D+/R−), intermediate-risk (D+/R+ or D−/R+), and low-risk (D−/R−). Therefore, recipients were divided into 4 groups: D−/R−, D−/R+, D+/R+ and D+/R−. Cancer data were obtained from the Office for National Statistics. The impact of CMV infection on survival and cancer incidence was assessed.8 

In the United States

Over a span of 22 years, the prevalence of CMV D+/R– in kidney, lung, heart, and liver solid organ transplant (SOT) recipients, respectively, increased significantly and is projected to continue to increase.9 

avg, average; CMV, cytomegalovirus; D+/R–, donor positive/recipient negative

CMV, cytomegalovirus; D+/R–, donor positive/recipient negative.

STUDY DESIGN: Imlay and colleagues obtained donor (D) and recipient (R) CMV serostatus and demographic factors from the Scientific Registry of Transplant Recipients for persons ≥18 years undergoing a first SOT between January 1, 2000 and December 31, 2020 in the United States. The proportions of D+/R– SOTs over time were assessed using Chi square for trend and modeled through 2040. Factors associated with D/R seropositivity were assessed using logistic models.9

References: 1. Haidar G, Boeckh M, Singh N. Cytomegalovirus infection in solid organ and hematopoietic cell transplantation: state of the evidence. J Infect Dis. 2020;221(Suppl 1):S23-S31. 2. Downes KJ, Sharova A, Boge CLK, et al. CMV infection and management among pediatric solid organ transplant recipients. Pediatric Transplant. 2022;26(3):e14220. doi:10.1111/petr.14220. 3. Hernandez C, Mabilangan C, Burton C, Doucette K, Preiksaitis J. Cytomegalovirus transmission in mismatched solid organ transplant recipients: Are factors other than anti-viral prophylaxis at play? Am J Transplant. 2021;21:3958–3970. doi:10.1111/ajt.16734 4. Zuhair M, Smit GSA, Wallis G et al. Estimation of the worldwide seroprevalence of cytomegalovirus: a systematic review and meta-analysis. Rev Med Virol. 2019;e2034. doi:10.1002/rmv.2034 5. Centers for Disease Control and Prevention. About Cytomegalovirus (CMV). https://www.cdc.gov/cmv/overview.html. Accessed February 9, 2024. 6. Fowler K, Mucha J, Neumann M, et al. A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development. BMC Public Health. 2022;22:1659. doi:10.1186/s12889-022-13971-7 7. Kotton CN, Kamar N. New insights on CMV management in solid organ transplant patients: prevention, treatment, and management of resistant/refractory disease. Infect Dis Ther. 2023;12:333-342. doi:10.1007/s40121-022-00746-1 8. Desai R, Collett D, Watson CJE, Johnson PJ, Moss P, Neuberger J. Impact of cytomegalovirus on long-term mortality and cancer risk after organ transplantation. Transplantation. 2015;99:1989-1994. 9. Imlay H, Wagener MM, Vutien P, Perkins J, Singh N, Limaye AP. Increasing proportion of high-risk cytomegalovirus donor-positive/recipient-negative serostatus in solid organ transplant recipients. Transplantation. 2023;107(4):988-993. 10. Grossi PA, Kamar N, Saliba F, et al. Cytomegalovirus management in solid organ transplant recipients: a pre-COVID-19 survey from the Working Group of the European Society for Organ Transplantation. Transpl Int. 2022;35:10332. doi:10.3389/ti.2022.10332   

You are now leaving the CYTOGAM site

Links to related resources are provided as a service to viewers. Kamada Inc. is not responsible for the content of linked sites.