Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023

Cytomegalovirus (CMV) infection poses significant challenges in solid organ transplant (SOT) recipients, impacting graft outcomes, morbidity, and in some cases survival. The ESOT CMV Workshop 2023 convened European experts to discuss current practices and advances in the management of CMV with the a...

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Main Authors: Luca Toti, Nassim Kamar, Sophie Alain, Oriol Manuel, Nikolina Basic-Jukic, Paolo Antonio Grossi, Hannah Kaminski, Paolo Solidoro, Luciano Potena
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Transplant International
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Online Access:https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14195/full
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author Luca Toti
Nassim Kamar
Sophie Alain
Sophie Alain
Oriol Manuel
Nikolina Basic-Jukic
Paolo Antonio Grossi
Hannah Kaminski
Paolo Solidoro
Luciano Potena
author_facet Luca Toti
Nassim Kamar
Sophie Alain
Sophie Alain
Oriol Manuel
Nikolina Basic-Jukic
Paolo Antonio Grossi
Hannah Kaminski
Paolo Solidoro
Luciano Potena
author_sort Luca Toti
collection DOAJ
description Cytomegalovirus (CMV) infection poses significant challenges in solid organ transplant (SOT) recipients, impacting graft outcomes, morbidity, and in some cases survival. The ESOT CMV Workshop 2023 convened European experts to discuss current practices and advances in the management of CMV with the aim of improving the quality of life of transplant recipients. Discussions covered crucial areas such as preventive strategies, diagnostic challenges, therapeutic approaches, and the role of cell-mediated immunity (CMI) monitoring. Despite advances, ambiguity persists in optimal CMV management across European transplant centers. Preventive strategies, including universal prophylaxis and pre-emptive therapy, are effective but consensus is lacking with respect to the preferred approach. Diagnostic challenges such as standardization of viral load thresholds and detection of end-organ disease complicate timely intervention. While newer therapies like maribavir hold promise for treating complicated CMV infections, sustaining viral clearance remains a challenge. Integrating CMI monitoring into CMV management could personalize treatment decisions but has limitations in in terms of predictive value and accessibility. Further research is needed to fill these gaps and optimize CMV management. The collaborative efforts, led by the European Society for Organ Transplantation (ESOT), aim to standardize and improve CMV care, ensuring better outcomes for SOT recipients.
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spelling doaj-art-7a8a12a6f9ef41e0b04fa7267204c98b2025-08-22T05:10:03ZengFrontiers Media S.A.Transplant International1432-22772025-08-013810.3389/ti.2025.1419514195Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023Luca Toti0Nassim Kamar1Sophie Alain2Sophie Alain3Oriol Manuel4Nikolina Basic-Jukic5Paolo Antonio Grossi6Hannah Kaminski7Paolo Solidoro8Luciano Potena9Department of Surgical Sciences, University of Rome “Tor Vergata”, Rome, ItalyDepartment of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, INFINITY-Inserm U1291-CNRS U5051, University Paul Sabatier, Toulouse, FranceDepartment of Virology and National Reference Center for Herpesviruses, Limoges University Hospital, UMR Inserm 1092, University of Limoges, Limoges, FranceUniversity Hospital Federation SUPORT, Limoges, FranceInfectious Diseases Service and Transplantation Center, University Hospital and University of Lausanne, Lausanne, SwitzerlandDepartment of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, CroatiaUniversità degli Studi dell’Insubria - ASST SetteLaghi, Varese, ItalyDepartment of Nephrology, Transplantation, Dialysis and Apheresis, Centre Hospitalier Universitaire Bordeaux, Bordeaux, FranceS.C.U Pneumologia, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Department of Medical Sciences, University of Turin, Turin, Italy0Unit for Heart Failure and Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyCytomegalovirus (CMV) infection poses significant challenges in solid organ transplant (SOT) recipients, impacting graft outcomes, morbidity, and in some cases survival. The ESOT CMV Workshop 2023 convened European experts to discuss current practices and advances in the management of CMV with the aim of improving the quality of life of transplant recipients. Discussions covered crucial areas such as preventive strategies, diagnostic challenges, therapeutic approaches, and the role of cell-mediated immunity (CMI) monitoring. Despite advances, ambiguity persists in optimal CMV management across European transplant centers. Preventive strategies, including universal prophylaxis and pre-emptive therapy, are effective but consensus is lacking with respect to the preferred approach. Diagnostic challenges such as standardization of viral load thresholds and detection of end-organ disease complicate timely intervention. While newer therapies like maribavir hold promise for treating complicated CMV infections, sustaining viral clearance remains a challenge. Integrating CMI monitoring into CMV management could personalize treatment decisions but has limitations in in terms of predictive value and accessibility. Further research is needed to fill these gaps and optimize CMV management. The collaborative efforts, led by the European Society for Organ Transplantation (ESOT), aim to standardize and improve CMV care, ensuring better outcomes for SOT recipients.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14195/fullcytomegalovirussolid organ transplant recipientsuniversal prophylaxispre-emptive therapycell-mediated immunity
spellingShingle Luca Toti
Nassim Kamar
Sophie Alain
Sophie Alain
Oriol Manuel
Nikolina Basic-Jukic
Paolo Antonio Grossi
Hannah Kaminski
Paolo Solidoro
Luciano Potena
Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023
Transplant International
cytomegalovirus
solid organ transplant recipients
universal prophylaxis
pre-emptive therapy
cell-mediated immunity
title Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023
title_full Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023
title_fullStr Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023
title_full_unstemmed Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023
title_short Advancements in Cytomegalovirus Management Among Solid Organ Transplant Recipients: Insights From the ESOT CMV Workshop 2023
title_sort advancements in cytomegalovirus management among solid organ transplant recipients insights from the esot cmv workshop 2023
topic cytomegalovirus
solid organ transplant recipients
universal prophylaxis
pre-emptive therapy
cell-mediated immunity
url https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14195/full
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