Cytomegalovirus infections following renal transplantation.

This collective review of the literature concerns posttransplantation cytomegalovirus (CMV) infections. In the author's view, patients without previous CMV infection are most often infected by viruses transmitted with the transplanted kidney, whereas patients with prior infections can be infected either from this source or by reactivation of latent CMV. Many posttransplantation CMV infections are asymptomatic or yield only mild systemic effects. A few patients suffer life-threatening disease. However, CMV infections might adversely affect survival of both graft and patient by contributing to graft rejection, weakening the graft recipient's immunity, or by other, more direct, means. Currently, there is no effective, specific treatment of these infections. It is predicted that CMV infections will cease to be a problem only when the means are found to specifically block transplantation immunity, thereby eliminating the need for systemic immunosuppression and eliminating low-level host-vs.-graft responses.