The effect of donor-recipient cytomegalovirus serology on adult liver transplantation: A single center experience

Panagiotis Tryphonopoulos, Debbie Weppler, Michele I. Morris, Cristina Russo, Seigo Nishida, David M. Levi, Jang Moon, Akin Tekin, Gennaro Selvaggi, Eddie Island, Leopoldo Arosemena, Phillip Ruiz, Andreas G. Tzakis

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

INTRODUCTION.: We investigated the outcomes of adult liver transplants, according to their donor-recipient cytomegalovirus (CMV) serology. MATERIALS AND METHODS.: We included in the study all adult primary liver transplants, from January 1, 2002, to December 31, 2005. Follow-up was until December 31, 2007. According to the donor-recipient CMV serology, patients were divided into positive-negative (PN), positive-positive, negative-negative, and negative-positive groups, and all received CMV prophylaxis for 4 months posttransplantation. Hepatitis C patients received conventional immunosuppression, whereas all other patients received either conventional treatment or alemtuzumab (Campath-1H) induction. RESULTS.: We studied 438 adult liver transplants. Comparisons were made between high-risk group patients (PN) versus all others: 5-year patient survival was 74.31% vs. 78.8%, (P=NS) and graft survival 63.87% vs. 74.77%, (P=0.042). Five-year freedom from rejection was 42.84% vs. 51.95% (P=0.036). CMV infection (n=3) or disease (n=27) was observed in 30 patients (PN [n=23], positive-positive [n=6], and negative-positive [n=1]). Incidence of CMV infection was 9.8% overall and 34.84% and 2.5%, respectively, for the PN group versus all others (P=0.0000). Patients who received Campath-1H induction did not have an increased incidence of CMV infections compared with those who received conventional immunosuppression. CONCLUSIONS.: In our center, in adult liver transplantation, CMV donor-recipient PN serology is associated with rejection, graft survival, and CMV infection but is not correlated with patient survival, Epstein-Barr virus (EBV) occurrence, or viral hepatitis recurrence. The introduction of more potent induction immunosuppression did not accentuate these negative outcomes.

Original languageEnglish (US)
Pages (from-to)1051-1057
Number of pages7
JournalTransplantation
Volume92
Issue number9
DOIs
StatePublished - Nov 15 2011

Keywords

  • CMV infection
  • CMV serology
  • Liver transplantation

ASJC Scopus subject areas

  • Transplantation

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