Cytomegalovirus Infections in Pediatric Solid Organ Transplant Patients

Cytomegalovirus (CMV) is one of the most important infectious agents after organ transplantation in children as it gives rise to morbidity, loss of the graft and mortality. CMV infection/disease is full of unknowns in terms of both prevention and treatment strategies in children; mostly, studies and guidelines for adult patients are used while the child is being evaluated. The serostatus of the donor and the recipient, the type of the organ transplanted and immunosuppressive treatment are risk factors of the disease, similar to adult patients. Pre-emptive combination prophylaxis and hybrid strategies are also used in children. These have both advantages and disadvantages but they can be used in children efficiently. Gancyclovir is used as the first drug choice for CMV and some recent studies suggest that valgancyclovir is also efficient in children. The choice of drug, the dosage of the drug, the duration of prophylaxis/treatment, the side effects of drug, the time required for tests during infection/disease and the efficacy of adjunctive treatment in children are questions that are waiting to be researched, and must be answered with multicenter, randomized and controlled studies.