Predicting and preventing cytomegalovirus infection in transplant recipients

Transplantation is a life-saving procedure for patients with end-stage organ disease, but requires immunosuppressive medications to prevent rejection. This increases risk and severity of infections that don’t normally affect healthy individuals, which contribute significantly to morbidity and mortality. One of the most common and significant of these is cytomegalovirus (CMV) which causes clinical disease and indirect effects such as rejection, secondary infections and decreased survival. Highly effective antivirals are available, but predicting at-risk patients to target their use is difficult and dosing can be complex particularly in the setting of kidney impairment, with a risk of side effects including neutropenia. This clinical research project aims to understand the optimal CMV prevention strategies in solid organ transplant recipients, to improve our understanding of how best to use valganciclovir prophylaxis and how to predict which patients are at highest risk using novel tests such as immune biomarkers. It will be based on an existing retrospective cohort of transplant recipients, but additional clinical data collection will be needed from electronic medical records. It will involve statistical analyses and other clinical research methodologies but no laboratory work. Previous experience using R is desirable but not essential. It will set the groundwork for future clinical trials of different preventative strategies. It is a collaborative project involving both the infectious diseases department (Dr Bradley Gardiner, Professor Anton Peleg) and lung transplant department (Professor Glen Westall). The specific scope of work can be adapted to suit the interests of the student.