The diagnosis of CMV pneumonitis in lung and heart/lung transplant patients by PCR compared with traditional laboratory criteria

Transplantation. 1993 Aug;56(2):342-7. doi: 10.1097/00007890-199308000-00017.


Polymerase chain reaction (PCR) amplification of CMV DNA recovered from bronchial alveolar lavage (BAL) and peripheral blood samples was compared with tissue culture, cytology, and/or histology for the earlier detection of CMV pneumonitis in 12 recipients of single-lung or heart/lung transplants. In patients with confirmed CMV pneumonitis, cytological evidence of CMV disease in BAL samples was detected 38 +/- 14 days posttransplantation, while tissue culture and PCR-positive results were noted as early as 30 +/- 4.0 days and 18 +/- 4.6 days, respectively. While PCR was positive earlier than culture in a number of cases, culture-positive results were subsequently obtained in each case, consistent with earlier detection of viral replication by PCR as opposed to detection of latent virus. CMV was detected by PCR in 6 of 24 blood samples from patients with confirmed or suspected CMV pneumonitis, while results of all 24 blood samples were negative when assayed by tissue culture. PCR-based testing was more sensitive than traditional tests, allowing detection of viral replication earlier than tissue culture in the posttransplant period. PCR could provide a powerful means of monitoring the immunocompromised patients in whom preemptive therapeutic intervention for CMV disease is desirable.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Bronchoalveolar Lavage Fluid / microbiology
  • Cytomegalovirus / genetics*
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / pathology
  • DNA, Viral / analysis*
  • DNA, Viral / blood
  • Female
  • Ganciclovir / therapeutic use
  • Heart-Lung Transplantation / adverse effects*
  • Humans
  • Lung Transplantation / adverse effects*
  • Male
  • Opportunistic Infections / blood
  • Opportunistic Infections / diagnosis*
  • Opportunistic Infections / pathology
  • Pneumonia / diagnosis*
  • Pneumonia / microbiology*
  • Pneumonia / pathology
  • Polymerase Chain Reaction*
  • Reproducibility of Results


  • DNA, Viral
  • Ganciclovir