Research Digest: CMV, Tuberculosis, and Transplant ID

Dr. Diana Florescu, UNMC ID Physician and co-author of two recent publications exploring transplant ID.

One of the most profound medical developments of the past century, organ transplantation, can prove to be one of the most dangerous. Infectious pathogens can hide in transplanted organs which, in combination with the immune-suppressive drugs crucial to transplantation success, makes post-transplant infectious complications a high priority for healthcare. This is the basis for Transplant ID, as a close working relationship with transplant surgery teams and ID physicians are necessary to manage these complex patients and resulting infections. Luckily, there is a science to preventing these infections using techniques ranging from donor screening to medical management post-surgery. As is the case with most of medicine, these techniques are informed by the research- of which our very own Dr. Florescu is a strong contributor, most recently in two publications exploring transplant infection surveillance and treatment, respectively. Read on for a brief summary of their findings.


One of the most feared pathogen which can be transmitted via organ donation is Mycobacterium tuberculosis (TB). In the first article, Dr. Florescu and other authors examine potential cases of donor-derived tuberculosis reported between 2008 and 2018. Of the 51 cases reported during this time period, 9 donors resulted in probable disease transmission to 35 organ recipients. Each of these donors were associated with at least one TB-related risk factor. On average, detection of transmission took 104 days and no reported recipient died of the infection. The authors note that these results underscore the importance of obtaining a detailed donor history based on known TB risk factors. Read the full paper here.


Another transplant associated infection is caused by cytomegalovirus (CMV). Unfortunately, current therapies for this infection are accompanied by significant concerns of toxicity. In the second article, the authors conduct a phase 3 clinical trial evaluating the use of maribavir as a superior treatment for refractory CMV infections in organ transplant recipients. They found that maribavir was superior to valganciclovir/ganciclovir, foscarnet, or cidofovir treatment in viral clearance, being 32% more effective than other tested regimens. Additionally, maribavir use was associated with significantly less toxicity, with lower reported rates of acute kidney injury and neutropenia. Read more here.


Congratulations Dr. Florescu on the interesting, impactful, and medically relevant work!

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