Cytomegalovirus-associated renal allograft rejection: new challenges for antiviral preventive strategies

Abstract

The adverse impact of cytomegalovirus (CMV) infection after solid organ transplantion is currently believed to be mediated primarily by its immunomodulatory effects. There is a large body of evidence showing that both CMV disease and asymptomatic viremia are independent risk factors for the development of allograft rejection. The aim of this article is to summarize mechanisms whereby CMV is involved in the development and progression of allograft rejection, with particular emphasis on renal transplant recipients. The article will also address the potential of anti-CMV preventive protocols designed to favorably affect the incidence of allograft rejection.

Keywords::

• allograft rejection
• CMV
• CMV-specific T-cell immunity
• cytomegalovirus
• pre-emptive antiviral therapy
• prophylaxis
• renal transplantation
• valacyclovir
• valganciclovir

Financial & competing interests disclosure

This study was supported by research project no. MSM0021620819 ‘Replacement of and Support to Some Vital Organs’, awarded by the Ministry of Education, Youth and Physical Training of the Czech Republic. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.