Key result
Current CMV prophylaxis and monitoring fail to prevent late-onset infection and resistance in thoracic transplants.
Why the study?
Thoracic organ transplant recipients face high cytomegalovirus morbidity but remain under-represented in clinical research, with management strategies largely extrapolated from other transplant populations.
This review highlights the ongoing challenges of late-onset CMV infection and antiviral resistance in thoracic organ transplant recipients, emphasizing the need for targeted management strategies.
Persistent CMV challenges in thoracic recipients warrant clinical vigilance; leaves open needs for immune monitoring trials and resistance strategies.
Background: Cytomegalovirus (CMV) is a major cause of morbidity following solid organ transplantation, with thoracic organ transplant recipients (TOTRs) representing one of the highest risk groups. Despite this elevated risk, TOTRs are under-represented in clinical research, and current management strategies are largely extrapolated from other transplant populations. Methods: This review synthesizes evidence on CMV epidemiology, clinical outcomes, prevention, and treatment in TOTRs. Key content: Despite the success of antiviral prophylaxis and pre-emptive monitoring strategies in reducing CMV-related complications in this population, late-onset infection and antiviral resistance remain major clinical challenges. We explore the potential role of CMV in chronic rejection, evaluate the utility of CMV cell-mediated immune monitoring, and review the clinical experience with novel antivirals in TOTRs. By identifying key evidence gaps and outlining priorities for future research, this review aims to support the development of targeted and more effective CMV management strategies in this high-risk population.
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Collis et al. (2026) conducted a review in Cytomegalovirus infections in thoracic organ transplant recipients. CMV management strategies was evaluated. Thoracic organ transplant recipients face major clinical challenges with late-onset CMV infection and antiviral resistance despite current antiviral prophylaxis and pre-emptive monitoring strategies.
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