Transplant represents an effective strategy in the management of chronic organ dysfunction. Nonetheless, life threatening risks remain, especially in the post-transplant; among them, human cytomegalovirus (CMV) is a major concern, currently causing active infections in at least one-third of transplant recipients. Microbiologist and transplant scientific societies redefined guidance on CMV disease prevention and the best use for universal prophylaxis and pre-emptive virological monitoring. Developments in molecular diagnostic supported the spread of the pre-emptive strategy, and quantitative Real Time-PCR assays has unravelled the potential of viral load measurement as a predictor of the infection development in CMV post-transplant management. However, despite the WHO 1st CMV International Standard, the standardization of diagnostic and clinical practice has been limited by the absence of algorithms for calculating conversion factor to International Units and the lack of shared monitoring procedure, both at national and international level. At a regional level, the Italian scientific societies, AMCLI (Italian Clinical Microbiologist Association), SITO (Organ Transplant Italian Society), GITMO (Italian Group for Bone Marrow Transplant), recently tried to define a consensus for post-transplant monitoring. The concerted practice encompasses molecular quantitative PCR assays technical aspects and endorses the relevance of immunologic monitoring for improvement in patient risk stratification and prognosis. Here, we provide an overview of the state of the art of CMV management strategies, with a specific focus on the clinical practices and on the scientific societies' initiatives that aim to implement international standardization guidelines at a national level.

中文翻译：

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意大利移植患者的CMV感染管理。

移植代表了治疗慢性器官功能障碍的有效策略。尽管如此，仍然存在威胁生命的风险，尤其是在移植后。其中，人类巨细胞病毒（CMV）是一个主要问题，目前在至少三分之一的移植接受者中引起活动性感染。微生物学家和移植科学协会重新定义了有关CMV疾病预防的指南，以及普遍预防和先发性病毒学监测的最佳用途。分子诊断学的发展支持了先发制人策略的普及，并且实时定量PCR分析定量方法揭示了病毒载量测量作为CMV移植后管理中感染发生发展的预测指标的潜力。但是，尽管有WHO第1 CMV国际标准，由于缺乏计算国际单位换算因子的算法以及缺乏国家和国际层面的共享监控程序，诊断和临床实践的标准化受到了限制。在地区一级，意大利科学协会AMCLI（意大利临床微生物学家协会），SITO（意大利器官移植协会），GITMO（意大利骨髓移植组织）最近试图为移植后监测达成共识。一致的实践涵盖了分子定量PCR分析技术方面的内容，并认可了免疫学监测对改善患者风险分层和预后的相关性。在这里，我们概述了CMV管理策略的最新发展，