Case series demonstrates effective viral control with maribavir in critically ill liver transplant recipients, highlighting its role when standard antivirals fail or cause toxicity.
Managing cytomegalovirus (CMV) infection in the post-transplant setting is frequently complicated by severe adverse effects from standard antiviral therapy or viral resistance. We report the cases of two critically ill liver transplant recipients in whom maribavir, a kinase inhibitor approved for refractory/resistant CMV, was used. In the first case, maribavir achieved rapid viral suppression in a 30-year-old patient with refractory CMV infection. In the second case, it served as effective salvage therapy, enabling bone marrow recovery following valganciclovir-induced toxicity while maintaining viral control. Although both patients ultimately succumbed to non-CMV-related ICU complications, maribavir demonstrated clinical utility in achieving virological control, providing a crucial alternative for complex cases where conventional options are limited.
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Santos et al. (2026) studied this question.
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