Effect of Antiviral Chemoprophylaxis on Adverse Clinical Outcomes Associated With Cytomegalovirus After Liver Transplantation

Walter C. Hellinger; Hugo Bonatti; Victor I. Machicao; Joseph D. Yao; Lisa M. Brumble; Salvador Alvarez; Stephen D. Weigand; Rolland C. Dickson; Denise M. Harnois; James R. Spivey; Wolf H. Stapelfeldt; Christopher B. Hughes; Justin H. Nguyen; Jeffery L. Steers
August 2006
Mayo Clinic Proceedings;Aug2006, Vol. 81 Issue 8, p1029
Academic Journal
OBJECTIVE: To assess the association between cytomegalovirus (CMV) serology of donor and recipient and adverse outcomes after liver transplantation in the era of effective antiviral chemoprophylaxis. PATIENTS AND METHODS: We performed a retrospective cohort study of 193 consecutive patients undergoing their first liver transplantation between February 1998 and July 2000 with targeted and preemptive ganciclovir chemoprophylaxis. Patients were divided into 4 groups by CMV serology of donor and recipient: donor-/recipient-; donor-/recipient+; donor+/recipient+; and donor+/recipient-. Survival to the end points of retransplantation, death, or survival to 1 year after transplantation (whichever occurred first) was assessed. Rates of bacterial, fungal, and CMV Infection and of CMV disease were recorded and compared. RESULTS: No significant differences were observed in the rates of retransplantation, death, or survival to 1 year among the 4 groups of patients. Despite significantly higher rates of CMV Infection in the donor+ groups, there were no differences in the rates of bacterial or fungal infection or of CMV disease. Rejection occurred least frequently In the donor-/recipient-group. CONCLUSION: The adverse effects of CMV on outcomes after liver transplantation have been diminished in the era of effective antiviral chemoprophylaxis.


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