PDF(Pubmed)
Abstract：
Cytomegalovirus (CMV) is the most important opportunistic viral pathogen in solid organ transplant (SOT) recipients. The Korean guideline for the prevention of CMV infection in SOT recipients was developed jointly by the Korean Society for Infectious Diseases and the Korean Society of Transplantation. CMV serostatus of both donors and recipients should be screened before transplantation to best assess the risk of CMV infection after SOT. Seronegative recipients receiving organs from seropositive donors face the highest risk, followed by seropositive recipients. Either antiviral prophylaxis or preemptive therapy can be used to prevent CMV infection. While both strategies have been demonstrated to prevent CMV infection post-transplant, each has its own advantages and disadvantages. CMV serostatus, transplant organ, other risk factors, and practical issues should be considered for the selection of preventive measures. There is no universal viral load threshold to guide treatment in preemptive therapy. Each institution should define and validate its own threshold. Valganciclovir is the favored agent for both prophylaxis and preemptive therapy. The evaluation of CMV-specific cell-mediated immunity and the monitoring of viral load kinetics are gaining interest, but there was insufficient evidence to issue recommendations. Specific considerations on pediatric transplant recipients are included.
摘要：
巨细胞病毒（CMV）是实体器官移植（SOT）接受者中最重要的机会性病毒病原体。韩国传染病学会和韩国移植学会共同制定了预防SOT接受者CMV感染的韩国指南。移植前应筛查供体和受体的CMV血清状态，以最好地评估SOT后CMV感染的风险。接受血清阳性供体器官的血清阴性受体面临最高的风险，其次是血清反应阳性的接受者。抗病毒预防或抢先治疗可用于预防CMV感染。虽然这两种策略已被证明可以预防移植后CMV感染，每个人都有自己的优点和缺点。CMV血清状态,移植器官,其他风险因素，选择预防措施应考虑实际问题。在抢先治疗中没有通用的病毒载量阈值来指导治疗。每个机构都应定义和验证自己的阈值。伐更昔洛韦是预防和抢先治疗的首选药物。CMV特异性细胞介导的免疫评估和病毒载量动力学的监测越来越感兴趣，但是没有足够的证据来提出建议。包括对小儿移植受者的具体考虑。
