Maribavir for Management of Cytomegalovirus in Lung Transplant Recipients: A Case Series and Literature Review

Lung transplant recipients represent a high-risk group for cytomegalovirus (CMV) infection and disease, even among solid organ transplant (SOT) recipients, due to multiple factors. Additionally, CMV has significant consequences in this group including pneumonitis, acute rejection, and chronic lung allograft dysfunction. For the past two plus decades, treatment of CMV in SOT recipients has been limited to off-label use of 4 antiviral medications associated with significant toxicities including myelosuppression and nephrotoxicity. In November 2021, maribavir became the first antiviral agent approved by the United States Food and Drug Administration for the treatment of resistant or refractory CMV in transplant recipients. Herein, we present two reports of the successful use of maribavir at our center along with a review the evidence for maribavir for CMV management in lung transplant recipients.