Laboratory diagnostic testing for cytomegalovirus infection in solid organ transplant patients

Hyeyoung Lee; Eun-Jee Oh

doi:10.4285/kjt.22.0001

Laboratory diagnostic testing for cytomegalovirus infection in solid organ transplant patients

Korean J Transplant. 2022 Mar 31;36(1):15-28. doi: 10.4285/kjt.22.0001.

Authors

Hyeyoung Lee¹, Eun-Jee Oh^{2

3}

Affiliations

¹ Department of Laboratory Medicine, International St. Mary's Hospital, College of Medicine, Catholic Kwandong University, Incheon, Korea.
² Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
³ Research and Development Institute for In Vitro Diagnostic Medical Devices of Catholic University of Korea, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

Human cytomegalovirus (CMV) infection, which is one of the most common complications in transplant recipients, increases the risk of graft loss and rejection. Laboratory strategies for diagnosing CMV infection rely on the measurement of viral DNAemia and CMV-specific cell-mediated immunity (CMV-CMI). The CMV quantitative nucleic acid amplification test (QNAT) enabled the spread of preemptive therapy and prompted recommendations for surveillance, diagnosis, and monitoring. Despite the implementation of the World Health Organization international standard for calibration, variability of QNAT persists due to technical issues. CMV immunoglobulin G serology is the standard method for CMV immune screening of transplant candidates and donors. Assays for CMV-CMI play an important role in helping to predict the risk and to develop an individualized CMV management plan. Genotypic testing for resistance is needed when drug-resistant CMV infection is suspected. Here, we review the state of the art of laboratory tests for CMV infection in solid organ transplantation.

Keywords: Cell-mediated immunity; Cytomegalovirus; Serology; Transplantation; Viral load.

Publication types

Review