Cytomegalovirus (CMV) After Organ Transplant
Cytomegalovirus (CMV) is a viral infection. CMV is a common virus that many people carry. In most people, it doesn’t cause serious symptoms. But in a person who has had an organ transplant, it can cause serious illness.
What Is CMV?
CMV is a virus related to the herpes virus. CMV is found in saliva, urine, semen, stool, tears, breastmilk, and blood. The virus is easily spread in households. In a healthy person, CMV causes few or no symptoms. Because of this, most people don’t know they have CMV. It’s not curable and is a lifetime infection. Once you have CMV, you will always have the virus in your body.
If a person has symptoms of active CMV, they may include:
Fatigue and weakness
Muscle aches and joint stiffness
But CMV can cause serious illness and even death in a person who has had an organ transplant. It can lead to serious infections from other causes. These may include infections from bacteria, viruses, or fungus. CMV can also lead to damage or failure of the new organ. And CMV can also make it more likely that your body will reject the new organ.
Risks of CMV after organ transplant
An organ transplant is a surgery to replace a diseased organ with a healthy organ. The organ comes from an organ donor. A donor organ may be infected with CMV. Or the person who receives the organ may already have CMV. Either way, a CMV infection can become serious after organ transplant. This is because of the antirejection drugs the person must take.
After a transplant, the new organ is at risk for rejection in a person’s body. Rejection is a normal reaction of the body to foreign tissue. When a new organ is placed in a person's body, the immune system sees the new organ as foreign and tries to attack it. Medicines are given to prevent this. They act on the immune system and suppress the immune system response to the new organ.
But when the immune system is suppressed, it can’t fight other infections as well. This includes CMV. A CMV infection may be severe when a person is taking antirejection medicine. This may happen several weeks or months after an organ transplant.
Diagnosis and treatment
CMV infection can be diagnosed with a blood test. You may also be tested for CMV before having an organ transplant. This may help your healthcare providers decide on a treatment plan for you. You may be given medicine before you have an organ transplant. Treatment is often done with antiviral medicine. You may also be given immunotherapy medicine. This helps your immune system fight the CMV virus better. You may need to take medicine for several months before or after your organ transplant.
August 15, 2018
Azevedo, Cytomegalovirus infection in transplant recipients, Clinics (2015); 70(7); 515-523., CMX001 to Prevent Cytomegalovirus Disease in Hematopoietic-Cell Transplantation. Marty, F. The New England Journal of Medicine. 2013, is. 369, pp. 1227-36., Cytomegalovirus in Renal Transplantation. Brennan, D. Journal of the American Society of Nephrology. 2001, is. 12, ed. 4, pp. 848-55.
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