New strategies for prevention and therapy of cytomegalovirus infection anddisease in solid-organ transplant recipients

In the past three decades since the inception of human organ transplantatio n, cytomegalovirus (CMV) has gained increasing clinical import because it i s a common pathogen in the immunocompromised transplant recipient. Patients may suffer from severe manifestations of this infection along with the thr eat of potential fatality. Additionally, the dynamic evolution of immunosup pressive and antiviral agents has brought forth changes in the natural hist ory of CMV infection and disease. Transplant Physicians now face the daunti ng task of recognizing and managing the changing spectrum of CMV infection and its consequences in the organ recipient. For the microbiology laborator y, the emphasis has been geared toward the development of more sophisticate d detection assays, including methods to detect emerging antiviral resistan ce. The discovery of novel antiviral chemotherapy is an important theme of clinical research. Investigations have also focused on preventative measure s for CMV disease in the solid-organ transplant population. In all, while m uch has been achieved in the overall management of CMV infection, the curre nt understanding of CMV pathogenesis and therapy still leaves much to be le arned before success can be claimed.