Controlling the Troll: Management of Cytomegalovirus Infection after Transplantation
Authors: Stephen Dummer
Journal: Annals of Internal Medicine (2005)

Editorials20 December 2005Controlling the Troll: Management of Cytomegalovirus Infection after TransplantationStephen Dummer, MDStephen Dummer, MDFrom Vanderbilt University Medical Center, Nashville, TN 37232.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-12-200512200-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Twenty-five years ago, Henry Balfour coined the phrase “troll of transplantation” to denote the insidious influence that cytomegalovirus (CMV) infection exerted on the outcome of transplantation (1). At that time, CMV was the most common serious pathogen in transplant recipients. Like the troll in the fairy tale, the virus was a hidden threat, latent in the recipient's or donor's tissues but ready to emerge under the pressure of immunosuppression. Although some patients only experienced subclinical CMV infection, other patients progressed to having overt CMV disease. These patients were readmitted to the hospital 1 to 2 months after transplantation and suffered ...References1. Balfour HH. Cytomegalovirus: the “transplant troll” takes its toll. Clin Microbiology Newsletter. 1980;2:1-3. CrossrefMedlineGoogle Scholar2. Cytomegalovirus. Am J Transplant. 2004;4 Suppl 10 51-8. [PMID: 15504213] CrossrefMedlineGoogle Scholar3. Preiksaitis JK, Brennan DC, Fishman J, Allen U. Canadian society of transplantation consensus workshop on cytomegalovirus management in solid organ transplantation final report. Am J Transplant. 2005;5:218-27. [PMID: 15643981] CrossrefMedlineGoogle Scholar4. Boeckh M, Boivin G. Quantitation of cytomegalovirus: methodologic aspects and clinical applications. Clin Microbiol Rev. 1998;11:533-54. [PMID: 9665982] CrossrefMedlineGoogle Scholar5. Cope AV, Sabin C, Burroughs A, Rolles K, Griffiths PD, Emery VC. 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Indirect outcomes associated with cytomegalovirus (opportunistic infections, hepatitis C virus sequelae, and mortality) in liver-transplant recipients with the use of preemptive therapy for 13 years. Transplantation. 2005;79:1428-34. [PMID: 15912115] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Stephen Dummer, MDAffiliations: From Vanderbilt University Medical Center, Nashville, TN 37232.Disclosures: Consultancies: Roche Labs; Honoraria: Roche Labs.Corresponding Author: Stephen Dummer, MD, Vanderbilt University Medical Center, 911 Oxford House, Nashville, TN 37232; e-mail, Stephen.[email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-Analysis: The Efficacy of Strategies To Prevent Organ Disease by Cytomegalovirus in Solid Organ Transplant Recipients Andre C. Kalil , Josh Levitsky , Elizabeth Lyden , Julie Stoner , and Alison G. Freifeld Controlling the Troll Andre C. Kalil , Elizabeth Lyden , and Julie Stoner Controlling the Troll Stephen Dummer Metrics Cited byUtility of Leflunomide in the Treatment of Complex Cytomegalovirus SyndromesThe use of consensus guidelines for management of cytomegalovirus infection in renal transplantationCytomegalovirus-associated allograft rejection in heart transplant patientsControlling the TrollAndre C. Kalil, MD, Elizabeth Lyden, MS, and Julie Stoner, PhD 20 December 2005Volume 143, Issue 12Page: 913-914KeywordsAntiviral therapyAntiviralsCytomegalovirus infectionDrug therapyDrugsInfectious diseasesOral administrationProphylaxisTransplantationViral diseases ePublished: 20 December 2005 Issue Published: 20 December 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...