ArticlePediatric transplantation2026
Transmission of Cytomegalovirus (CMV) from CMV-Seropositive Organ Donors to CMV-Seronegative Pediatric Solid Organ Transplant (SOT) Recipients.
Article in Pediatric transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe risk factors for donor-acquired (DA) CMV transmission in CMV-seronegative pediatric solid organ transplant (SOT) recipients (R-) receiving organs from CMV-seropositive donors (D+) remain unknown in the era of routine antiviral prophylaxis.
methodsDA-CMV transmission was defined as CMV antigenemia/DNAemia and/or seroconversion in a D+/R- recipient by 13 months post-transplant. DA-CMV transmission, along with donor and recipient demographics, was studied in a retrospective cohort of CMV D+/R- children who had a SOT at the Stollery Children's Hospital from 2000 to 2018. All patients were expected to receive at least 3 months of CMV-active antiviral prophylaxis.
results105 CMV D+/R- pediatric SOT recipients (48 liver, 35 heart, 4 lung, 18 kidney) were analyzed; DA-CMV transmission occurred in 58 patients (55%). Frequency of DA-CMV transmission was highest in lung (75%), followed by liver (69%), then kidney (61%), and was lowest in heart recipients (31%). Median time to DA-CMV transmission was 4.8 months (3.4-6.7). In a multivariable cox regression model including organ, donor and recipient age and sex, risk of DA-CMV transmission was significantly lower in heart versus liver recipients (HR 0.30, 95% CI 0.14, 0.65, p = 0.003).
conclusionUnderstanding factors that result in non-transmission of CMV to seronegative recipients despite receiving a seropositive organ may guide more targeted use of antiviral prophylaxis in pediatric SOT recipients.
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