Chapter 6 : Infections in Organ Transplant Recipients

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $30.00

Preview this chapter:
Zoom in

Infections in Organ Transplant Recipients, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815981/9781555814250_Chap06-1.gif /docserver/preview/fulltext/10.1128/9781555815981/9781555814250_Chap06-2.gif


Organ transplantation represents a continually expanding field of medicine, and with each innovative method for subverting the natural process of host immunity, new and unusual presentations for virus infections have occurred. With the increasing use of xenotransplantation, the concern about introducing viral zoonoses increases. But from a management standpoint, CMV, EBV, adenovirus (AV), and hepatitis virus infections consume a major focus of attention. However, certain unusual infections such as rabies, West Nile virus, and Creutzfeldt-Jakob disease (CJD) can be a concern after transplantation and are discussed in this chapter. Cytomegalovirus (CMV) produces disease principally in the immunologically impaired individual and, in doing so, demonstrates considerable variability in the types of clinical syndromes that are seen in different at-risk groups. In the transplant population, all aspects of the clinical manifestations of Epstein-Barr virus (EBV) infection can be seen, and for this reason, EBV is among the most important infectious problems after either hematopoietic cell transplantation (HCT) or solidorgan transplantation (SOT). The common respiratory virus infections, i.e., with respiratory syncytial virus, parainfluenza virus, influenza virus, and human metapneumovirus, occur in transplant patients, and except for the potential for serious pulmonary complications, the infections are not qualitatively different from those seen in otherwise healthy populations. The chapter also talks about adenovirus (AV) infection and herpesviruses.

Citation: Zaia J. 2009. Infections in Organ Transplant Recipients, p 81-96. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch6

Key Concept Ranking

West nile virus
Hepatitis E virus
Hepatitis B virus
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of FIGURE 1

Occurrence of the most frequent virus infections after transplantation. Shown are the times after both SOT and marrow transplantation that recipients present with characteristic types of virus infections, ranging from HSV at the earliest time to CMV, EBV, and HHV-6 at 1 to 3 months after transplantation and AV, VZV, polyomavirus, and hepatitis viruses at later times.

Citation: Zaia J. 2009. Infections in Organ Transplant Recipients, p 81-96. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch6
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Ahuja, M.,, E. P. Cohen,, A. M. Dayer,, B. Kampalath,, C. C. Chang,, B. A. Bresnahan, and, S. Hariharan. 2001. Polyoma virus infection after renal transplantation. Use of immunostaining as a guide to diagnosis. Transplantation 71:896899.
2. Andersson, J.,, B. Skoldenberg,, W. Henle,, G. Giesecke,, A. Ortqvist, and, I. Julander. 1986. Effect of acyclovir on infectious mononucleosis: a double-blind, placebocontrolled study. J. Infect. Dis. 153:283290.
3. Andreoni, M.,, D. Goletti,, P. Pezzotti,, A. Pozzetto,, P. Monini,, L. Sarmati,, F. Farchi,, G. Tisone,, A. Piazza,, F. Pisani,, M. Angelico,, P. Leone,, F. Citterio,, B. Ensoli, and, G. Rezza. 2001. Prevalence, incidence and correlates of HHV-8/KSHV infection and Kaposi’s sarcoma in renal and liver transplant recipients. J. Infect. 43:195199.
4. Baksh, F. K.,, S. D. Finkelstein,, P. A. Swalsky,, G. L. Stoner,, C. F. Ryschkewitsch, and, P. Randhawa. 2001. Molecular genotyping of BK and JC viruses in human polyomavirus-associated interstitial nephritis after renal transplantation. Am. J. Kidney Dis. 38:354365.
5. Balfour, H. H.,, Jr., B. A. Chace,, J. T. Stapleton,, R. L. Simmons, and, D. S. Fryd. 1989. A randomized, placebo-controlled trial of oral acyclovir for the prevention of cytomegalovirus disease in recipients of renal allografts. N. Engl. J. Med. 320:13811387.
6. Bando, K.,, I. L. Paradis,, S. Similo,, H. Konishi,, K. Komatsu,, T. G. Zullo,, S. A. Yousem,, J. M. Close,, A. Zeevi, and, R. J. Duquesnoy. 1995. Obliterative bronchiolitis after lung and heart-lung transplantation. An analysis of risk factors and management. J. Thorac. Cardiovasc. Surg. 110:413.
7. Barton, T. D.,, E. A. Blumberg,, A. Doyle,, V. N. Ahya,, J. M. Ferrenberg,, S. C. Brozena, and, A. P. Limaye. 2006. A prospective cross-sectional study of BK virus infection in non-renal solid organ transplant recipients with chronic renal dysfunction. Transplant Infect. Dis. 8:102107.
8. Basgoz, N.,, and J. K. Preiksaitis. 1995. Post-transplant lymphoproliferative disorder. Infect. Dis. Clin. N. Am. 9:901923.
9. Bedi, A.,, C. B. Miller,, J. L. Hanson,, S. Goodman,, R. F. Ambinder,, P. Charache,, R. R. Arthur, and, R. J. Jones. 1995. Association of BK virus with failure of prophylaxis against hemorrhagic cystitis following bone marrow transplantation. J. Clin. Oncol. 13:11031109.
10. Boeckh, M.,, H. W. Kim,, M. E. Flowers,, J. D. Meyers, and, R. A. Bowden. 2006. Long-term acyclovir for prevention of varicella zoster virus disease after allogeneic hematopoietic cell transplantation—a randomized double-blind placebo-controlled study. Blood 107:18001805.
11. Boeckh, M.,, W. Leisenring,, S. R. Riddell,, R. A. Bowden,, M. L. Huang,, D. Myerson,, T. Stevens-Ayers,, M. E. Flowers,, T. Cunningham, and, L. Corey. 2003. Late cytomegalovirus disease and mortality in recipients of allogeneic hematopoietic stem cell transplants: importance of viral load and T-cell immunity. Blood 101:407414.
12. Bogdanovic, G.,, P. Ljungman,, F. Wang, and, T. Dalianis. 1996. Presence of human polyomavirus DNA in the peripheral circulation of bone marrow transplant patients with and without hemorrhagic cystitis. Bone Marrow Transplant. 17:573576.
13. Boker, K.,, G. Dalley, and, M. Bahr. 1997. Long-term outcome of hepatitis C virus infection after liver transplantation. Hepatology 25:203210.
14. Boland, G. J.,, R. J. Hene,, C. Ververs,, M. A. M. DeHaan, and, G. C. DeGast. 1993. Factors influencing the occurrence of active cytomegalovirus (CMV) infections after organ transplantation. Clin. Exp. Immunol. 94:306312.
15. Bowden, R. A.,, S. J. Slichter,, M. H. Sayers,, M. Mori,, M. J. Cays, and, J. D. Meyers. 1991. Use of leukocyte-depleted platelets and cytomegalovirus-seronegative red blood cells for prevention of primary cytomegalovirus infection after marrow transplant. Blood 78:246250.
16. Bronster, D. J.,, M. W. Lidov,, D. Wolfe,, M. E. Schwartz, and, C. M. Miller. 1995. Progressive multifocal leukoencephalopathy after orthotopic liver transplantation. Liver Transplant. Surg. 1:371372.
17. Brown, P.,, J. P. Brandel,, M. Preece, and, T. Sato. 2006. Iatrogenic Creutzfeldt-Jakob disease: the waning of an era. Neurology 67:389393.
18. Bruno, B.,, T. Gooley,, R. C. Hackman,, C. Davis,, L. Corey, and, M. Boeckh. 2003. Adenovirus infection in hematopoietic stem cell transplantation: effect of ganciclovir and impact on survival. Biol. Blood Marrow Transplant. 9:341352.
19. Bruno, B.,, R. Sorasio,, P. Barozzi,, J. Vieira,, P. Omede,, F. Giaretta,, M. Rotta,, L. Giaccone,, M. Massaia,, M. Luppi, and, M. Boccadoro. 2006. Kaposi’s sarcoma triggered by endogenous HHV-8 reactivation after nonmyeloablative allogeneic haematopoietic transplantation. Eur. J. Haematol. 76:342347.
20. Buchsbaum, R. J.,, J. A. Fabry, and, J. Lieberman. 1996. EBV-specific cytotoxic T lymphocytes protect against human EBV-associated lymphoma in scid mice. Immunol. Lett. 52:145150.
21. Cen, H.,, M. C. Breinig,, R. W. Atchison,, M. Ho, and, J. L. McKnight. 1991. Epstein-Barr virus transmission via the donor organs in solid organ transplantation: polymerase chain reaction and restriction fragment length polymorphism analysis of IR2, IR3, and IR4. J. Virol. 65:976980.
22. Centers for Disease Control and Prevention. 2001. U.S. Public Health Service guideline on infectious disease issues in xenotransplantation. Morb. Mortal. Wkly. Rep. Recomm. Rep. 50:146.
23. Chakrabarti, S. 2007. Adenovirus infections after hematopoietic stem cell transplantation: still unravelling the story. Clin. Infect. Dis. 45:966968.
24. Chou, S. W. 1986. Acquisition of donor strains of cytomegalovirus by renal-transplant recipients. N. Engl. J. Med. 314:14181423.
25. Cobbold, M.,, N. Khan,, B. Pourgheysari,, S. Tauro,, D. McDonald,, H. Osman,, M. Assenmacher,, L. Billingham,, C. Steward,, C. Crawley,, E. Olavarria,, J. Goldman,, R. Chakraverty,, P. Mahendra,, C. Craddock, and, P. A. Moss. 2005. Adoptive transfer of cytomegalovirus-specific CTL to stem cell transplant patients after selection by HLA-peptide tetramers. J. Exp. Med. 202:379386.
26. Cohen, J. I. 1991. Epstein-Barr virus lymphoproliferative disease associated with acquired immunodeficiency. Medicine (Baltimore) 70:1760.
27. Cole, N. L.,, and H. H. Balfour, Jr. 1987. In vitro susceptibility of cytomegalovirus isolates from immunocompromised patients to acyclovir and ganciclovir. Diagn. Microbiol. Infect. Dis. 6:255261.
28. Collins, S. J.,, V. A. Lawson, and, C. L. Masters. 2004. Transmissible spongiform encephalopathies. Lancet 363:5161.
29. Cwynarski, K.,, J. Ainsworth,, M. Cobbold,, S. Wagner,, P. Mahendra,, J. Apperley,, J. Goldman,, C. Craddock, and, P. A. Moss. 2001. Direct visualization of cytomegalovirus-specific T-cell reconstitution after allogeneic stem cell transplantation. Blood 97:12321240.
30. Davis, C. L.,, D. R. Gretch, and, R. L. Carithers, Jr. 1995. Hepatitis B and transplantation. Infect. Dis. Clin. N. Am. 9:925941.
31. Davis, C. L.,, K. L. Harrison,, J. P. McVicar,, P. J. Forg,, M. P. Bronner, and, C. L. Marsh. 1995. Antiviral prophylaxis and the Epstein-Barr virus-related post-transplant lymphoproliferative disorder. Clin. Transplant. 9:5359.
32. de Bruyn, G.,, and A. P. Limaye. 2004. BK virus-associated nephropathy in kidney transplant recipients. Rev. Med. Virol. 14:193205.
33. De Clercq, E.,, L. Naesens,, L. De Bolle,, D. Schols,, Y. Zhang, and, J. Neyts. 2001. Antiviral agents active against human herpesviruses HHV-6, HHV-7 and HHV-8. Rev. Med. Virol. 11:381395.
34. Deodhar, S. D.,, A. G. Kuklinca,, D. Vidt,, A. L. Robertson, and, J. B. Hazard. 1969. Development of reticulum-cell sarcoma at the site of antilymphocyte globulin injection in a patient with renal transplant. N. Engl. J. Med. 280:11041106.
35. Dodson, S. F.,, M. E. de Vera,, C. A. Bonham,, D. A. Geller,, J. Rakela, and, J. J. Fung. 2000. Lamivudine after hepatitis B immune globulin is effective in preventing hepatitis B recurrence after liver transplantation. Liver Transplant. 6:434439.
36. Dunn, D. L.,, K. J. Gillingham,, M. A. Kramer,, W. J. Schmidt,, A. Erice,, H. H. Balfour, Jr.,, P. F. Gores,, R. W. B. Gruessner,, A. J. Matas,, W. D. Payne,, D. E. R. Sutherland, and, J. S. Najarian. 1994. A prospective randomized study of acyclovir versus ganciclovir plus human immune globulin prophylaxis for cytomegalovirus infection after solid organ transplantation. Transplantation 57:876884.
37. Einsele, H.,, G. Ehninger,, H. Hebart,, P. Weber,, S. Dette,, H. Link,, H. P. Horny,, V. Meuter,, S. Wagner,, H. D. Waller, et al. 1994. Incidence of local CMV infection and acute intestinal GVHD in marrow transplant recipients with severe diarrhoea. Bone Marrow Transplant. 14:955963.
38. Einsele, H.,, E. Roosnek,, N. Rufer,, C. Sinzger,, S. Riegler,, J. Loffler,, U. Grigoleit,, A. Moris,, H. G. Rammensee,, L. Kanz,, A. Kleihauer,, F. Frank,, G. Jahn, and, H. Hebart. 2002. Infusion of cytomegalovirus (CMV)-specific T cells for the treatment of CMV infection not responding to antiviral chemotherapy. Blood 99:39163922.
39. Elstrom, R. L.,, C. Andreadis,, N. A. Aqui,, V. N. Ahya,, R. D. Bloom,, S. C. Brozena,, K. M. Olthoff,, S. J. Schuster,, S. D. Nasta,, E. A. Stadtmauer, and, D. E. Tsai. 2006. Treatment of PTLD with rituximab or chemotherapy. Am. J. Transplant. 6:569576.
40. Evans, P. C.,, A. Soin,, T. G. Wreghitt,, C. J. Taylor,, D. G. Wight, and, G. J. Alexander. 2000. An association between cytomegalovirus infection and chronic rejection after liver transplantation. Transplantation 69:3035.
41. Fujii, Y.,, K. Kaku,, M. Tanaka, and, T. Kaneko. 1994. Hepatitis C virus infection and liver disease after allogeneic bone marrow transplantation. Bone Marrow Transplant. 13:523526.
42. Gane, E.,, F. Saliba,, G. J. C. Valdecasas,, J. O’Grady,, M. D. Pescovitz,, S. Lyman, and, C. A. Robinson for The Oral Ganciclovir International Transplantation Study Group. 1997. Randomised trial of efficacy and safety of oral ganciclovir in the prevention of cytomegalovirus disease in liver-transplant recipients. Lancet 350:17291733.
43. Gane, E. J.,, B. C. Portmann, and, N. V. Naoumouv. 1996. Long-term outcome of hepatitis C infection after liver transplantation. N. Engl. J. Med. 334:821827.
44. Goodrich, J. M.,, R. A. Bowden,, L. Fisher,, C. Keller,, G. Schoch, and, J. D. Meyers. 1993. Ganciclovir prophylaxis to prevent cytomegalovirus disease after allogeneic marrow transplant. Ann. Intern. Med. 118:173178.
45. Goodrich, J. M.,, M. Mori,, C. A. Gleaves,, C. Du Mond,, M. Cays,, D. F. Ebeling,, W. C. Buhles,, B. DeArmond, and, J. D. Meyers. 1991. Early treatment with ganciclovir to prevent cytomegalovirus disease after allogeneic bone marrow transplantation. N. Engl. J. Med. 325:16011607.
46. Gratama, J. W.,, and J. J. Cornelissen. 2003. Diagnostic potential of tetramer-based monitoring of cytomegalovirus-specific CD8+ T lymphocytes in allogeneic stem cell transplantation. Clin. Immunol. 106:2935.
47. Gratama, J. W.,, J. A. P. Oosterveer,, J. M. M. Lepoutre,, J. J. van Rood,, F. E. Zwaan,, J. M. J. J. Vossen,, J. G. Kapsenberg,, D. Richel,, G. Klein, and, I. Ernberg. 1990. Serological and molecular studies of Epstein-Barr virus infection in allogeneic marrow graft recipients. Transplantation 49:725730.
48. Grattan, M. T.,, C. E. Moreno-Cabral,, V. A. Starnes,, P. E. Oyer,, E. B. Stinson, and, N. E. Shumway. 1989. Cytomegalovirus infection is associated with cardiac allograft rejection and atherosclerosis. JAMA 261:35613566.
49. Grekas, D.,, C. Dioudis,, K. Mandraveli, and, P. Alivanis. 1995. Renal transplantation in asymptomatic carriers of hepatitis B surface antigen. Nephron 69:267272.
50. Han, S. H.,, J. Ofman,, C. Holt,, K. King,, G. Kunder,, P. Chen,, S. Dawson,, L. Goldstein,, H. Yersiz,, D. G. Farmer,, R. M. Ghobrial,, R. W. Busuttil, and, P. Martin. 2000. An efficacy and cost-effectiveness analysis of combination hepatitis B immune globulin and lamivudine to prevent recurrent hepatitis B after orthotopic liver transplantation compared with hepatitis B immune globulin monotherapy. Liver Transplant. 6:741748.
51. Hanto, D. W.,, G. Fizzera, and, K. J. Gajl-Peczalska. 1982. Epstein-Barr virus (EBV)-induced B cells lymphoma after renal transplantation: acyclovir therapy and transition from polyclonal to monoclonal B-cell proliferation. N. Engl. J. Med. 306:913918.
52. Henle, G.,, W. Henle, and, R. Dielh. 1968. Relation of Burkitt’s tumor-associated herpes-type virus to infectious mononucleosis. Proc. Natl. Acad. Sci. USA 59:94101.
53. Hibberd, P. L.,, and D. R. Snydman. 1995. Cytomegalovirus infection in organ transplant recipients. Infect. Dis. Clin. N. Am. 9:863877.
54. Ho, M. 1991. Cytomegalovirus, Biology and Infection, 2nd ed. Plenum Publishing, New York, NY.
55. Ho, M.,, G. Miller, and, R. W. Atchinson. 1985. Epstein-Barr virus infections and DNA hybridization studies in post-transplantation lymphoma and lymphoproliferative lesions: the role of primary infection. J. Infect. Dis. 152:876886.
56. Ho, M.,, S. Suwansirikul,, J. N. Dowling,, L. A. Youngblood, and, J. A. Armstrong. 1975. The transplanted kidney as a source of cytomegalovirus infections. N. Engl. J. Med. 293:11091112.
57. Hoffman, J. A.,, A. J. Shah,, L. A. Ross, and, N. Kapoor. 2001. Adenoviral infections and a prospective trial of cidofovir in pediatric hematopoietic stem cell transplantation. Biol. Blood Marrow Transplant. 7:388394.
58. Höglund, M.,, P. Ljungman, and, S. Weller. 2001. Comparable aciclovir exposures produced by oral valaciclovir and intravenous aciclovir in immunocompromised cancer patients. J. Antimicrob. Chemother. 47:855861.
59. Ison, M. G. 2007. Respiratory viral infections in transplant recipients. Antivir. Ther. 12:627638.
60. Iwamoto, M.,, D. B. Jernigan,, A. Guasch,, M. J. Trepka,, C. G. Blackmore,, W. C. Hellinger,, S. M. Pham,, S. Zaki,, R. S. Lanciotti,, S. E. Lance-Parker,, C. A. Diaz-Granados,, A. G. Winquist,, C. A. Perlino,, S. Wiersma,, K. L. Hillyer,, J. L. Goodman,, A. A. Marfin,, M. E. Chamberland, and, L. R. Petersen. 2003. Transmission of West Nile virus from an organ donor to four transplant recipients. N. Engl. J. Med. 348:21962203.
61. Jacobson, M. A.,, and J. Mills. 1988. Serious cytomegalovirus disease in the acquired immunodeficiency syndrome (AIDS). Clinical findings, diagnosis, and treatment. Ann. Intern. Med. 108:585594.
62. Kadakia, M. P.,, W. B. Rybka, and, J. A. Stewart. 1996. Human herpesvirus-6 infection in bone marrow transplantation. Blood 87:53415354.
63. Kadambi, P. V.,, M. A. Josephson,, J. Williams,, L. Corey,, K. R. Jerome,, S. M. Meehan, and, A. P. Limaye. 2003. Treatment of refractory BK virus-associated nephropathy with cidofovir. Am. J. Transplant. 3:186191.
64. Kalil, A. C.,, J. Levitsky,, E. Lyden,, J. Stoner, and, A. G. Freifeld. 2005. Meta-analysis: the efficacy of strategies to prevent organ disease by cytomegalovirus in solid organ transplant recipients. Ann. Intern. Med. 143:870880.
65. Kanich, R. E. 1966. Human cytomegalovirus and cytomegalovirus disease in renal homotransplant recipients. Am. J. Med. 40:88748882.
66. Kenagy, D. N.,, Y. Schlesinger,, K. Weck,, J. H. Ritter,, M. M. Gaudreault-Keener, and, G. A. Storch. 1995. Epstein-Barr virus DNA in peripheral blood leukocytes of patients with posttransplant lymphoproliferative disease. Transplantation 60:547.
67. Khoury, J. A.,, G. A. Storch,, D. L. Bohl,, R. M. Schuessler,, S. M. Torrence,, M. Lockwood,, M. Gaudreault-Keener,, M. J. Koch,, B. W. Miller,, K. L. Hardinger,, M. A. Schnitzler, and, D. C. Brennan. 2006. Prophylactic versus preemptive oral valganciclovir for the management of cytomegalovirus infection in adult renal transplant recipients. Am. J. Transplant. 6:21342143.
68. Klein, G. 1994. Epstein-Barr virus strategy in normal and neoplastic B cells. Cell 77:791793.
69. Klein, G. 1979. Lymphoma development in mice and human: diversity of initiation is followed by convergent cytogenetic evolution. Proc. Natl. Acad. Sci. USA 76:24422446.
70. Klemola, E. 1973. Cytomegalovirus infection in previously healthy adults. Ann. Intern. Med. 79:267268.
71. Kraemer, C.,, S. Evers,, T. Nolting,, G. Arendt, and, I. W. Husstedt. 18 January 2008. Cidofovir in combination with HAART and survival in AIDS-associated progressive multifocal leukoencephalopathy. J. Neurol. doi:10.1007/s00415-008-0731-z.
72. Krause, H.,, H. Hebart,, G. Jahn,, C. A. Muller, and, H. Einsele. 1997. Screening for CMV-specific T cell proliferation to identify patients at risk of developing late onset CMV disease. Bone Marrow Transplant. 19:11111116.
73. Krymskaya, L.,, M. C. Sharma,, J. Martinez,, W. Haq,, E. C. Huang,, A. P. Limaye,, D. J. Diamond, and, S. F. Lacey. 2005. Cross-reactivity of T lymphocytes recognizing a human cytotoxic T-lymphocyte epitope within BK and JC virus VP1 polypeptides. J. Virol. 79:1117011178.
74. Lacey, S. F.,, D. J. Diamond, and, J. A. Zaia. 2004. Assessment of cellular immunity to human cytomegalovirus in recipients of allogeneic stem cell transplants. Biol. Blood Marrow Transplant. 10:433447.
75. Lacey, S. F.,, G. Gallez-Hawkins,, M. Crooks,, J. Martinez,, D. Senitzer,, S. J. Forman,, R. Spielberger,, J. A. Zaia, and, D. J. Diamond. 2002. Characterization of cytotoxic function of CMV-pp65-specific CD8+ T-lymphocytes identified by HLA tetramers in recipients and donors of stem-cell transplants. Transplantation 74:722732.
76. Leen, A. M.,, G. D. Myers,, U. Sili,, M. H. Huls,, H. Weiss,, K. S. Leung,, G. Carrum,, R. A. Krance,, C. C. Chang,, J. J. Molldrem,, A. P. Gee,, M. K. Brenner,, H. E. Heslop,, C. M. Rooney, and, C. M. Bollard. 2006. Monoculture-derived T lymphocytes specific for multiple viruses expand and produce clinically relevant effects in immunocompromised individuals. Nat. Med. 12:11601166.
77. Leget, G. A.,, and M. S. Czuczman. 1998. Use of rituximab, the new FDA-approved antibody. Curr. Opin. Oncol. 10:548551.
78. Li, C. R.,, P. D. Greenberg,, M. J. Gilbert,, J. M. Goodrich, and, S. R. Riddell. 1994. Recovery of HLA-restricted cytomegalovirus (CMV)-specific T-cell responses after allogeneic bone marrow transplant: correlation with CMV disease and effect of ganciclovir prophylaxis. Blood 83:19711979.
79. Limaye, A. P.,, L. Corey,, D. M. Koelle,, C. L. Davis, and, M. Boeckh. 2000. Emergence of ganciclovir-resistant cytomegalovirus disease among recipients of solid-organ transplants. Lancet 356:645649.
80. Limaye, A. P.,, M. L. Huang,, E. E. Atienza,, J. M. Ferrenberg, and, L. Corey. 1999. Detection of Epstein-Barr virus DNA in sera from transplant recipients with lymphoproliferative disorders. J. Clin. Microbiol. 37:11131116.
81. Limaye, A. P.,, K. R. Jerome,, C. S. Kuhr,, J. Ferrenberg,, M. L. Huang,, C. L. Davis,, L. Corey, and, C. L. Marsh. 2001. Quantitation of BK virus load in serum for the diagnosis of BK virus-associated nephropathy in renal transplant recipients. J. Infect. Dis. 183:16691672.
82. Ljungman, P.,, J. Aschan,, J. N. Azinge,, L. Brandt,, A. Ehrnst,, V. Hammarström,, S. Klaesson,, A. Linde,, B. Lönnqvist,, O. Ringdén, et al. 1993. Cytomegalovirus viraemia and specific T-helper cell responses as predictors of disease after allogeneic marrow transplantation. Br. J. Haematol. 83:118124.
83. Ljungman, P.,, G. L. Deliliers,, U. Platzbecker,, S. Matthes-Martin,, A. Bacigalupo,, H. Einsele,, J. Ullmann,, M. Musso,, R. Trenschel,, P. Ribaud,, M. Bornhäuser,, S. Cesaro,, B. Crooks,, A. Dekker,, N. Gratecos,, T. Klingebiel,, E. Tagliaferri,, A. J. Ullmann,, P. Wacker, and, C. Cordonnier for the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. 2001. Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients. Blood 97:388392.
84. Ljungman, P.,, N. Johansson,, J. Aschan, and, H. Glaumann. 1995. Long-term effects of hepatitis C virus infection in allogeneic bone marrow transplant recipients. Blood 86:16141618.
85. Ljungman, P.,, G. Oberg,, J. Aschan,, A. Ehrnst,, B. Lonnqvist,, K. Pauksen, and, P. Sulila. 1996. Foscarnet for pre-emptive therapy of CMV infection detected by a leukocyte-based nested PCR in allogeneic bone marrow transplant patients. Bone Marrow Transplant. 18:565568.
86. Ljungman, P.,, P. Ribaud,, M. Eyrich,, S. Matthes-Martin,, H. Einsele,, M. Bleakley,, M. Machaczka,, M. Bierings,, A. Bosi,, N. Gratecos, and, C. Cordonnier. 2003. Cidofovir for adenovirus infections after allogeneic hematopoietic stem cell transplantation: a survey by the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant. 31:481486.
87. Locasciulli, A.,, A. Alberti,, G. Bandini, and, P. Polchi. 1995. Allogeneic bone marrow transplantation from HBsAg+ donors: a multicenter study from the Gruppo Italiano Trapianto di Midollo Osseo (GITMO). Blood 86:32363240.
88. Lowance, D.,, H.-H. Neumayer,, C. M. Legendre,, J.-P. Squifflet,, J. Kovarik,, P. J. Brennan,, D. Norman,, R. Mendez,, M. R. Keating,, G. L. Coggon,, A. Crisp, and, I. C. Lee for The International Valacyclovir Cytomegalovirus Prophylaxis Transplantation Study Group. 1999. Valacyclovir for the prevention of cytomegalovirus disease after renal transplantation. N. Engl. J. Med. 340:14621470.
89. Luppi, M.,, P. Barozzi,, V. Rasini,, G. Riva,, A. Re,, G. Rossi,, G. Setti,, S. Sandrini,, F. Facchetti, and, G. Torelli. 2002. Severe pancytopenia and hemophagocytosis after HHV-8 primary infection in a renal transplant patient successfully treated with foscarnet. Transplantation 74:131132.
90. Maruta, A.,, H. Kanamori,, H. Fukawa, and, H. Harano. 1994. Liver function tests of recipients with hepatitis C virus infection after bone marrow transplantation. Bone Marrow Transplant. 13:417422.
91. Meyers, J. D.,, N. Flournoy, and, E. D. Thomas. 1982. Nonbacterial pneumonia after allogeneic marrow transplantation: a review of ten years’ experience. Rev. Infect. Dis. 4:11191132.
92. Meyers, J. D.,, N. Flournoy, and, E. D. Thomas. 1986. Risk factors for cytomegalovirus infection after human marrow transplantation. J. Infect. Dis. 153:478488.
93. Meyers, J. D.,, P. Ljungman, and, L. D. Fisher. 1990. Cytomegalovirus excretion as a predictor of cytomegalovirus disease after marrow transplantation: importance of cytomegalovirus viremia. J. Infect. Dis. 162:373380.
94. Meyers, J. D.,, E. C. Reed,, D. H. Shepp,, M. Thornquist,, P. S. Dandliker,, C. A. Vicary,, N. Flournoy,, L. E. Kirk,, J. H. Kersey,, E. D. Thomas, et al. 1988. Acyclovir for prevention of cytomegalovirus infection and disease after allogeneic marrow transplantation. N. Engl. J. Med. 318:7075.
95. Micallef, I. N.,, M. Chhanabhai,, R. D. Gascoyne,, J. D. Shepherd,, H. C. Fung,, S. H. Nantel,, C. L. Toze,, H. G. Klingemann,, H. J. Sutherland,, D. E. Hogge,, T. J. Nevill,, A. Le, and, M. J. Barnett. 1998. Lymphoproliferative disorders following allogeneic bone marrow transplantation: the Vancouver experience. Bone Marrow Transplant. 22:981987.
96. Myers, G. D.,, C. M. Bollard,, M. F. Wu,, H. Weiss,, C. M. Rooney,, H. E. Heslop, and, A. M. Leen. 2007. Reconstitution of adenovirus-specific cell-mediated immunity in pediatric patients after hematopoietic stem cell transplantation. Bone Marrow Transplant. 39:677686.
97. Nalesnik, M. A.,, R. Jaffe, and, T. E. Starzl. 1988. The pathology of post-transplant lymphoproliferative disorders occurring in the setting of cyclosporine-A prednisone immunosuppression. Am. J. Pathol. 133:173192.
98. Nephrology Dialysis Transplantation. 2002. European best practice guidelines for renal transplantation. Section IV: long-term management of the transplant recipient. IV.6.1. Cancer risk after renal transplantation. Post-transplant lymphoproliferative disease (PTLD): prevention and treatment. Nephrol. Dial. Transplant. 17(Suppl. 4):3133, 35–36.
99. Nichols, W. G.,, L. Corey,, T. Gooley,, C. Davis, and, M. Boeckh. 2002. High risk of death due to bacterial and fungal infection among cytomegalovirus (CMV)-seronegative recipients of stem cell transplants from seropositive donors: evidence for indirect effects of primary CMV infection. J. Infect. Dis. 185:273282.
100. Nichols, W. G.,, L. Corey,, T. Gooley,, W. L. Drew,, R. Miner,, M. Huang,, C. Davis, and, M. Boeckh. 2001. Rising pp65 antigenemia during preemptive anticytomegalovirus therapy after allogeneic hematopoietic stem cell transplantation: risk factors, correlation with DNA load, and outcomes. Blood 97:867874.
101. Noguchi-Shinohara, M.,, T. Hamaguchi,, T. Kitamoto,, T. Sato,, Y. Nakamura,, H. Mizusawa, and, M. Yamada. 2007. Clinical features and diagnosis of dura mater graft associated Creutzfeldt Jakob disease. Neurology 69:360367.
102. Okano, M.,, G. M. Thiele, and, J. R. Davis. 1988. Epstein-Barr virus and human diseases: recent advances in diagnosis. Clin. Microbiol. Rev. 1:300312.
103. Ozdemir, F. N.,, A. Akgul,, A. Altunoglu,, A. Bilgic,, Z. Arat, and, M. Haberal. 2007. The association between cytomegalovirus infection and atherosclerotic events in renal transplant recipients. Transplant. Proc. 39:990992.
104. Papadopoulos, E. B.,, M. Ladanyi,, D. Emanuel, and, S. Mackinnon. 1994. Infusions of donor leukocytes to treat Epstein-Barr virus-associated lymphoproliferative disorders after allogeneic bone marrow transplantation. N. Engl. J. Med. 330:11851191.
105. Paradis, K.,, G. Langford,, Z. Long,, W. Heneine,, P. Sandstrom,, W. M. Switzer,, L. E. Chapman,, C. Lockey,, D. Onions, and, E. Otto for The XEN 111 Study Group. 1999. Search for cross-species transmission of porcine endogenous retrovirus in patients treated with living pig tissue. Science 285:12361241.
106. Patience, C.,, Y. Takeuchi, and, R. A. Weiss. 1998. Zoonosis in xenotransplantation. Curr. Opin. Immunol. 10:539542.
107. Penn, I.,, W. Hammond,, L. Brettschneider, and, T. E. Starzl. 1969. Malignant lymphomas in transplantation patients. Transplant. Proc. 1:106112.
108. Pouteil-Noble, C.,, J. C. Tardy,, P. Chossegros,, F. Mion,, M. Chevallier,, F. Gérard,, P. Chevallier,, F. Megas,, N. Lefrançois, and, J. L. Touraine. 1995. Co-infection by hepatitis B virus and hepatitis C virus in renal transplantation: morbidity and mortality in 1098 patients. Nephrol. Dial. Transplant. 10(Suppl. 6):122124.
109. Preiksaitis, J.,, F. Diaz-Mitoma, and, F. Mirzayans. 1992. Quantitative oropharyngeal Epstein-Barr virus shedding in renal and cardiac transplant recipients: relationship to immunosuppressive therapy, serological responses and the risk of post-transplant lymphoproliferative disorder. J. Infect. Dis. 166:986994.
110. Prentice, H. G.,, E. Gluckman,, R. L. Powles,, P. Ljungman,, N. J. Milpied,, R. Camara,, F. Mandelli,, P. Kho,, L. Kennedy, and, A. R. Bell for the European Acyclovir for CMV Prophylaxis Study Group. 1997. Long-term survival in allogeneic bone marrow transplant recipients following acyclovir prophylaxis for CMV infection. Bone Marrow Transplant. 19:129133.
111. Pruett, T. L.,, and R. McGory. 2000. Hepatitis B immune globulin: the US experience. Clin. Transplant. 14:713.
112. Purtilo, D. R.,, R. S. Strobach,, M. Okano, and, J. R. Davis. 1992. Biology of disease: Epstein-Barr virus-associated lymphoproliferative disorders. Lab. Investig. 67:523.
113. Quinnan, G. V.,, Jr., N. Kirmani,, A. H. Rook,, J. F. Manischewitz,, L. Jackson,, G. Moreschi,, G. W. Santos,, R. Saral, and, W. H. Burns. 1982. Cytotoxic T cells in cytomegalovirus infection: HLA-restricted T-lymphocyte and non-T-lymphocyte cytotoxic responses correlate with recovery from cytomegalovirus infection in bone-marrow-transplant recipients. N. Engl. J. Med. 307:713.
114. Raab-Traub, N.,, K. Flynn,, C. Klein,, G. Pizza,, C. De Vinci,, L. Occhiuzzi,, G. Farneti,, U. Caliceti, and, E. Pirodda. 1987. EBV associated malignancies. J. Exp. Pathol. 3:449456.
115. Renoult, E.,, B. Aymard,, M. J. Gregoire, and, A. Bellow. 1995. Epstein-Barr virus lymphoproliferative disease of donor origin after kidney transplantation: a case report. Am. J. Kidney Dis. 26:8487.
116. Resnick, L.,, J. S. Herbst,, D. V. Ablashi,, S. Atherton,, B. Frank, and, L. Rosen. 1988. Regression of oral hairy leukoplakia after orally administered acyclovir therapy. JAMA 259:384388.
117. Reusser, P.,, S. R. Riddell,, J. D. Meyers, and, P. D. Greenberg. 1991. Cytotoxic T-lymphocyte response to cytomegalovirus after human allogeneic bone marrow transplantation: pattern of recovery and correlation with cytomegalovirus infection and disease. Blood 78:13731380.
118. Rubin, R. H.,, A. B. Cosimi,, N. E. Tolkoff-Rubin,, P. S. Russell, and, M. S. Hirsch. 1977. Infectious disease syndromes attributable to cytomegalovirus and their significance among renal transplant recipients. Transplantation 24:458464.
119. Rubin, R. H. 1990. Impact of cytomegalovirus infection on organ transplant recipients. Rev. Infect. Dis. 12(Suppl. 7):S754S766.
120. Saemundsen, A. K.,, D. T. Purtilo,, K. Sakamoto,, J. L. Sullivan,, A. C. Synnerholm,, D. Hanto,, R. Simmons,, M. Anvret,, R. Collins, and, G. Klein. 1981. Documentation of Epstein-Barr virus infection in immunodeficient patients with life-threatening lymphoproliferative diseases by Epstein-Barr virus complementary RNA/DNA and viral DNA/DNA hybridization. Cancer Res. 41:42374242.
121. Salzberger, B.,, R. A. Bowden,, R. C. Hackman,, C. Davis, and, M. Boeckh. 1997. Neutropenia in allogeneic marrow transplant recipients receiving ganciclovir for prevention of cytomegalovirus disease: risk factors and outcome. Blood 90:25022508.
122. Sanchez-Fueyo, A.,, M. Gimenez-Barcons,, F. Puig-Basagoiti,, A. Rimola,, J. M. Sanchez-Tapias,, J. C. Saiz, and, J. Rodes. 2001. Influence of the dynamics of the hypervariable region 1 of hepatitis C virus (HCV) on the histological severity of HCV recurrence after liver transplantation. J. Med. Virol. 65:266275.
123. Schmidt, G. M.,, D. A. Horak,, J. C. Niland,, S. R. Duncan,, S. J. Forman, and, J. A. Zaia for The City of Hope-Stanford-Syntex CMV Study Group. 1991. A randomized, controlled trial of prophylactic ganciclovir for cytomegalovirus pulmonary infection in recipients of allogeneic bone marrow transplants. N. Engl. J. Med. 324:10051011.
124. Shapiro, R. S.,, K. McClain, and, G. Frizzera. 1988. Epstein-Barr virus associated B cell lymphoproliferative disorders following bone marrow transplantation. Blood 71:12341243.
125. Shuahart, M. C.,, D. Myerson,, B. H. Childs, and, J. D. Fingeroth. 1994. Marrow transplantation from hepatitis C virus seropositive donors: transmission rate and clinical course. Blood 85:32293235.
126. Singh, N. 2006. Antiviral drugs for cytomegalovirus in transplant recipients: advantages of preemptive therapy. Rev. Med. Virol. 16:281287.
127. Sivaprakasam, P.,, T. F. Carr,, M. Coussons,, T. Khalid,, A. S. Bailey,, M. Guiver,, K. J. Mutton,, A. J. Turner,, J. D. Grainger, and, R. F. Wynn. 2007. Improved outcome from invasive adenovirus infection in pediatric patients after hemopoietic stem cell transplantation using intensive clinical surveillance and early intervention. J. Pediatr. Hematol. Oncol. 29:8185.
128. Smith, M. A.,, S. Sundaresan,, T. Mohanakumar,, E. P. Trulock,, J. P. Lynch,, D. L. Phelan,, J. D. Cooper, and, G. A. Patterson. 1998. Effect of development of antibodies to HLA and cytomegalovirus mismatch on lung transplantation survival and development of bronchiolitis obliterans syndrome. J. Thorac. Cardiovasc. Surg. 116:812820.
129. Srinivasan, A.,, E. C. Burton,, M. J. Kuehnert,, C. Rupprecht,, W. L. Sutker,, T. G. Ksiazek,, C. D. Paddock,, J. Guarner,, W. J. Shieh,, C. Goldsmith,, C. A. Hanlon,, J. Zoretic,, B. Fischbach,, M. Niezgoda,, W. H. El-Feky,, L. Orciari,, E. Q. Sanchez,, A. Likos,, G. B. Klintmalm,, D. Cardo,, J. LeDuc,, M. E. Chamberland,, D. B. Jernigan, and, S. R. Zaki. 2005. Transmission of rabies virus from an organ donor to four transplant recipients. N. Engl. J. Med. 352:11031111.
130. Stevens, S. J. C.,, E. A. M. Verschuuren,, I. Pronk,, W. van der Big,, M. C. Harmsen,, T. H. The,, C. J. L. M. Meijer,, A. J. C. van den Brule, and, J. M. Middeldorp. 2001. Frequent monitoring of Epstein-Barr virus DNA load in unfractionated whole blood is essential for early detection of posttransplant lymphoproliferative disease in high-risk patients. Blood 97:11651171.
131. Sullivan, J. L.,, K. S. Byron,, F. E. Brewster,, K. Sakamoto,, J. E. Show, and, J. S. Pagano. 1982. Treatment of life-threatening Epstein-Barr virus infection with acyclovir. Am. J. Med. 73:262266.
132. Suzuki, T.,, Y. Takano,, K. Yamashita, and, K. Sato. 1993. A possible role for Epstein-Barr virus in tumorigenesis after immunosuppression in cases of renal transplantation. J. Cancer Res. Clin. Oncol. 119:627629.
133. Toupance, O.,, M. C. Bouedjoro-Camus,, J. Carquin,, J. L. Novella,, S. Lavaud,, A. Wynckel,, D. Jolly, and, J. Chanard. 2000. Cytomegalovirus-related disease and risk of acute rejection in renal transplant recipients: a cohort study with case-control analyses. Transplant Int. 13:413419.
134. Trappe, R.,, H. Riess,, N. Babel,, M. Hummel,, H. Lehmkuhl,, S. Jonas,, I. Anagnostopoulos,, M. Papp-Vary,, P. Reinke,, R. Hetzer,, B. Dorken, and, S. Oertel. 2007. Salvage chemotherapy for refractory and relapsed posttransplant lymphoproliferative disorders (PTLD) after treatment with single-agent rituximab. Transplantation 83:912918.
135. Tu, W.,, L. Potena,, P. Stepick-Biek,, L. Liu,, K. Y. Dionis,, H. Luikart,, W. F. Fearon,, T. H. Holmes,, C. Chin,, J. P. Cooke,, H. A. Valantine,, E. S. Mocarski, and, D. B. Lewis. 2006. T-cell immunity to subclinical cytomegalovirus infection reduces cardiac allograft disease. Circulation 114:16081615.
136. van Esser, J. W. J.,, B. van der Holt,, E. Meijer,, H. G. M. Niesters,, R. Trenschel,, S. F. T. Thijsen,, A. M. van Loon,, F. Frassoni,, A. Bacigalupo,, U. W. Schaefer,, A. D. M. E. Osterhaus,, J. W. Gratama,, B. Lowenberg,, L. F. Verdonck, and, J. J. Cornelissen. 2001. Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell-depleted SCT. Blood 98:972978.
137. Vusirikala, M.,, S. N. Wolff,, R. S. Stein,, S. J. Brandt,, D. S. Morgan,, J. P. Greer,, F. G. Schuening,, J. S. Dummer, and, S. A. Goodman. 2001. Valacyclovir for the prevention of cytomegalovirus infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis. Bone Marrow Transplant. 28:265270.
138. Walker, R. C.,, C. C. V. Paya,, W. F. Marshall,, J. G. Strickler,, R. H. Wiesner,, J. A. Veloza,, T. M. Habermann,, R. C. Daly, and, C. G. McGregor. 1995. Pretransplantation seronegative Epstein-Barr virus status is the primary risk factor for posttransplant lymphoproliferative disorder in adult heart, lung, and other solid organ transplantations. J. Heart Lung Transplant. 14:214221.
139. Walter, E. A.,, P. D. Greenberg,, M. J. Gilbert,, R. J. Finch,, K. S. Watanabe,, E. D. Thomas, and, S. R. Riddell. 1995. Reconstitution of cellular immunity against cytomegalovirus in recipients of allogeneic bone marrow by transfer of T-cell clones from the donor. N. Engl. J. Med. 333:10381044.
140. Wang, F. Z.,, A. Linde,, H. Hagglund,, M. Testa,, A. Locasciulli, and, P. Ljungman. 1999. Human herpesvirus 6 DNA in cerebrospinal fluid specimens from allogeneic bone marrow transplant patients: does it have clinical significance? Clin. Infect. Dis. 28:562568.
141. Weiss, L. M.,, and K. L. Chang. 1992. Molecular biologic studies of Hodgkin’s disease. Semin. Diagn. Pathol. 9:272278.
142. Weiss, L. M.,, L. A. Movahed,, R. A. Warnke, and, J. Sklar. 1989. Detection of Epstein-Barr viral genomes in Reed-Stemberg cells of Hodgkin’s disease. N. Engl. J. Med. 320:502506.
143. Weller, T. H.,, J. C. Macauley,, J. M. Craig, and, P. Wirth. 1957. Isolation of intranuclear inclusion producing agents from infants with illnesses resembling cytomegalic inclusion disease. Proc. Soc. Exp. Biol. Med. 94:412.
144. Wingard, J. R.,, D. Y. Chen,, W. H. Burns,, D. J. Fuller,, H. G. Braine,, A. M. Yeager,, H. Kaiser,, P. J. Burke,, M. L. Graham, and, G. W. Santos. 1988. Cytomegalovirus infection after autologous bone marrow transplantation with comparison to infection after allogeneic bone marrow transplantation. Blood 71:14321437.
145. Yao, Q. Y.,, P. Ogan,, M. Rowe,, M. Wood, and, A. B. Rickinson. 1989. Epstein-Barr virus-infected B cells persist in the circulation of acyclovir-treated virus carriers. Int. J. Cancer 43:6771.
146. Zaia, J. A. 2004. Cytomegalovirus infection, p. 701–726. In K. G. Blume,, S. J. Forman, and, F. R. Appelbaum (ed.), Thomas’ Hematopoietic Cell Transplantation. Blackwell Publications, Boston, MA.
147. Zaia, J. A.,, and D. J. Lang. 1984. Cytomegalovirus infection of the fetus and neonate. Neurol. Clin. 2:387410.
148. Zutter, M. M.,, P. J. Martin,, G. E. Sale,, H. M. Shulman,, L. Fisher,, E. D. Thomas, and, D. M. Durnam. 1988. Epstein-Barr virus lymphoproliferation after bone marrow transplantation. Blood 72:520529.


Generic image for table

Risk factors for CMV complications in the transplant recipient

Citation: Zaia J. 2009. Infections in Organ Transplant Recipients, p 81-96. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch6
Generic image for table

CMV prophylaxis in transplant recipients

Citation: Zaia J. 2009. Infections in Organ Transplant Recipients, p 81-96. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch6

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error