Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of Taiwan
Kidney transplant recipients have an increased risk of cytomegalovirus (CMV) infection and disease. A strategy for mitigating the risk of CMV infection in kidney transplant recipients has not yet been established in Taiwan. The Transplantation Society of Taiwan aimed to develop a consensus by expert...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Journal of the Formosan Medical Association |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664624002456 |
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| author | Mu-Chi Chung Cheng-Hsu Chen Shen-Shin Chang Chih-Yuan Lee Ya-Chung Tian Mei-Yi Wu Hsu-Han Wang Chia-Cheng Yu Teng-Wei Chen Chien-Chang Kao Chih-Yang Hsu Yang-Jen Chiang Ming-Ju Wu Yen-Ta Chen Mai-Szu Wu |
| author_facet | Mu-Chi Chung Cheng-Hsu Chen Shen-Shin Chang Chih-Yuan Lee Ya-Chung Tian Mei-Yi Wu Hsu-Han Wang Chia-Cheng Yu Teng-Wei Chen Chien-Chang Kao Chih-Yang Hsu Yang-Jen Chiang Ming-Ju Wu Yen-Ta Chen Mai-Szu Wu |
| author_sort | Mu-Chi Chung |
| collection | DOAJ |
| description | Kidney transplant recipients have an increased risk of cytomegalovirus (CMV) infection and disease. A strategy for mitigating the risk of CMV infection in kidney transplant recipients has not yet been established in Taiwan. The Transplantation Society of Taiwan aimed to develop a consensus by expert opinion on the prevention and management of CMV infection. Based on the results of Consensus Conference, we suggested low-dose valganciclovir prophylaxis (450 mg once daily) for kidney transplant recipients. The prophylaxis duration was ≥6 months for high-risk (D+/R-) patients and 3 months for moderate-risk (R+) patients. Even for low-risk (D-/R-) patients, prophylaxis for at least 3 months is recommended because of the high seroprevalence of CMV in Taiwan. CMV prophylaxis was suggested after anti-thymocyte globulin treatment but not after methylprednisolone pulse therapy. Routine surveillance after prophylaxis, secondary prophylaxis after CMV disease treatment, and mTOR inhibitors for primary CMV prophylaxis were not recommended. Letermovir and marabavir are emerging CMV agents used for prophylaxis and refractory CMV disease. CMV immunoglobulins have been used to treat refractory CMV disease in Taiwan. We hope this consensus will help professionals manage patients with CMV in Taiwan to improve the quality of care. |
| format | Article |
| id | doaj-art-c34f9a3eda7944098d357bbc264bed4f |
| institution | Kabale University |
| issn | 0929-6646 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-c34f9a3eda7944098d357bbc264bed4f2025-02-02T05:26:46ZengElsevierJournal of the Formosan Medical Association0929-66462025-02-011242104111Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of TaiwanMu-Chi Chung0Cheng-Hsu Chen1Shen-Shin Chang2Chih-Yuan Lee3Ya-Chung Tian4Mei-Yi Wu5Hsu-Han Wang6Chia-Cheng Yu7Teng-Wei Chen8Chien-Chang Kao9Chih-Yang Hsu10Yang-Jen Chiang11Ming-Ju Wu12Yen-Ta Chen13Mai-Szu Wu14Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan; Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan; Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Ph.D. Program in Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Life Science, Tunghai University, Taichung, TaiwanDivision of Transplantation, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Surgery, National Taiwan University Hospital, TaiwanKidney Research Center and Department of Nephrology Linkou Chang Aging Memorial Hospital, TaiwanDivision of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan; Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, TaiwanDepartment of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, TaiwanDivision of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Urology, Department of Surgery, Tri-service General Hospital, National Defense Medical, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, TaiwanDepartment of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan; Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan; TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Corresponding author.Kidney transplant recipients have an increased risk of cytomegalovirus (CMV) infection and disease. A strategy for mitigating the risk of CMV infection in kidney transplant recipients has not yet been established in Taiwan. The Transplantation Society of Taiwan aimed to develop a consensus by expert opinion on the prevention and management of CMV infection. Based on the results of Consensus Conference, we suggested low-dose valganciclovir prophylaxis (450 mg once daily) for kidney transplant recipients. The prophylaxis duration was ≥6 months for high-risk (D+/R-) patients and 3 months for moderate-risk (R+) patients. Even for low-risk (D-/R-) patients, prophylaxis for at least 3 months is recommended because of the high seroprevalence of CMV in Taiwan. CMV prophylaxis was suggested after anti-thymocyte globulin treatment but not after methylprednisolone pulse therapy. Routine surveillance after prophylaxis, secondary prophylaxis after CMV disease treatment, and mTOR inhibitors for primary CMV prophylaxis were not recommended. Letermovir and marabavir are emerging CMV agents used for prophylaxis and refractory CMV disease. CMV immunoglobulins have been used to treat refractory CMV disease in Taiwan. We hope this consensus will help professionals manage patients with CMV in Taiwan to improve the quality of care.http://www.sciencedirect.com/science/article/pii/S0929664624002456 |
| spellingShingle | Mu-Chi Chung Cheng-Hsu Chen Shen-Shin Chang Chih-Yuan Lee Ya-Chung Tian Mei-Yi Wu Hsu-Han Wang Chia-Cheng Yu Teng-Wei Chen Chien-Chang Kao Chih-Yang Hsu Yang-Jen Chiang Ming-Ju Wu Yen-Ta Chen Mai-Szu Wu Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of Taiwan Journal of the Formosan Medical Association |
| title | Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of Taiwan |
| title_full | Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of Taiwan |
| title_fullStr | Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of Taiwan |
| title_full_unstemmed | Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of Taiwan |
| title_short | Prevention and management of cytomegalovirus infection and disease in kidney transplant: A consensus statement of the Transplantation Society of Taiwan |
| title_sort | prevention and management of cytomegalovirus infection and disease in kidney transplant a consensus statement of the transplantation society of taiwan |
| url | http://www.sciencedirect.com/science/article/pii/S0929664624002456 |
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