No matter how you define high-risk, consider Cytogam®

While CMV infection and CMV disease have been documented in recipients of all solid organ transplant types, the definition of what constitutes high-risk varies.

For one thing, the risk of CMV disease differs by organ transplant type. Recipients of lung, heart-lung and pancreas transplants incur the highest risk. Liver and heart transplant recipients are at intermediate risk, and kidney allograft recipients are at the lowest risk for developing CMV disease.1

Since the risk of developing symptomatic CMV disease is highest in D+R- patients (seronegative recipients of organs from seropositive donors)2 some consider all transplants of this kind to be high-risk.

Given the arduous procedure involved, all heart-lung transplant patients are considered high-risk.3

It’s also widely believed that heightened immunosuppression (such as Campath®, Thymoglobulin®, Simulect® and Zenapax®) may place all transplant patients in the high-risk category.2,4,5

Cytogam® is a registered trademark of CSL Behring LLC. All others should be trademarked to their respective companies.

Degree of CMV Risk Based on CMV Status 6

1. Snydman DR. Infection in solid organ transplantation. Transpl Infect Dis. 1999;1(1):21-8.

2. Fishman JA, Emery V, Freeman R, et al. Cytomegalovirus in transplantation—challenging the status quo. Clin Transplant. 2007;21:149-58.

3. Valantine HA, Luikart H, Doyle R, et al. Impact of cytomegalovirus hyperimmune globulin on outcome after cardiothoracic transplantation: a comparative study of combined prophylaxis with CMV hyperimmune globulin plus ganciclovir versus ganciclovir alone. Transplantation. 2001;72:1647-52.

4. Snydman DR, Werner BG, Heinze-Lacey B, et al. Use of cytomegalovirus immune globulin to prevent cytomegalovirus disease in renal-transplant recipients. N Engl J Med. 1987;317:1049-54.

5. Razonable RR. Epidemiology of cytomegalovirus disease in solid organ and hematopoietic stem cell transplant recipients. Am J Health Syst Pharm. Apr 15 2005;62(8 Suppl 1):S7-13.

6. Sia M, Patel R. New strategies for prevention and therapy of cytomegalovirus infection and disease in solid-organ transplant recipients. Clin Microbiol Rev. 2000;13:83-121.