Cytomegalovirus (CMV) After Organ Transplant

Cytomegalovirus (CMV) is a viral infection. CMV is a common virus that many people carry. In most people it does not cause serious symptoms. However, in a person who has had an organ transplant it can cause serious illness.

What Is CMV

CMV is a virus related to the herpes virus. CMV is found in saliva, urine, semen, and blood. The virus is easily spread in households. In a healthy person, CMV causes few or no symptoms. Therefore most healthy people do not know they have CMV.

It is not curable and is a lifetime infection. Once you have CMV, you will always have the virus in your body.

If a healthy person has symptoms, they may include:

• Fever
• Sore throat
• Swollen glands
• Fatigue
• Flu-like symptom
• Muscle aches
• Diarrhea

For a person who has had an organ transplant, CMV can cause complications, serious illness, and even death. It can lead to serious infections from other causes including bacteria, viruses, or fungus. CMV can lead to damage or failure of the new organ. CMV can also make it more likely that your body will reject the new transplanted organ.

Risks of CMV after organ transplant

An organ transplant is a surgery to replace a diseased organ with a healthy organ. The organ comes from an organ donor. A donor organ may be infected with CMV, or the person who receives the organ may already have CMV. Either way, a CMV infection can become serious after organ transplant because of the antirejection medicines the person must take.

After a transplant, the new organ is at risk for rejection in a person’s body. Rejection is a normal reaction of the body to foreign tissue. When a new organ is placed in a person's body, the immune system sees the new organ as a foreign body and tries to attack it.

Medicines called antirejection medicines are given protect the transplanted organ and fight rejection. These medicines weaken the immune systems and when the immune system is weakened to prevent rejection of an organ transplant, it cannot fight other infections as well, including CMV. As a result, a CMV infection may become more severe. This can happen several weeks or months after an organ transplant.

Diagnosis and treatment

A CMV infection can be diagnosed with a blood test. You should be tested for CMV before having an organ transplant so that your healthcare providers can decide on a treatment plan for you.

You may be given medicine before you have an organ transplant. Treatment is often done with antiviral medicine. A reduction in your anti-rejection medicines may also be recommended.  These treatments allow your immune system to fight the CMV infection better.