BACKGROUND Cytomegalovirus(CMV)is the most common viral pathogen after liver transplantation(LT).Although reactivation of CMV infection is generally described in the context of immunosuppression,it has also been descr...BACKGROUND Cytomegalovirus(CMV)is the most common viral pathogen after liver transplantation(LT).Although reactivation of CMV infection is generally described in the context of immunosuppression,it has also been described in critically ill immunocompetent patients including cirrhotic patients.AIM To determine the incidence of reactivated CMV prior to LT.METHODS This was a prospective cohort study evaluating adult patients who underwent LT between 2014 and 2016.A plasma sample was obtained from all patients for CMV quantitative real-time PCR testing right before transplantation.Patients were followed for at least 1 year to assess the following outcomes:Incidence of CMV infection,organ rejection and overall mortality.RESULTS A total of 72 patients were enrolled.Four patients died before transplantation,thus 68 patients were followed up for a median of 44 mo(20-50 mo).In 23/72 patients(31.9%)CMV was reactivated before transplantation.Post-transplantation,16/68(23.5%)patients had CMV infection and that was significantly associated with the recipient being CMV negative and a CMV-positive donor.Pretransplant CMV reactivation was not associated with overall mortality(log rank:0.9).CONCLUSION This study shows that CMV infection is common in patients with chronic liver disease just before LT,but the clinical impact of this infection seems to be negligible.展开更多
基金Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)–Brazil,No.479880/2012-3.
文摘BACKGROUND Cytomegalovirus(CMV)is the most common viral pathogen after liver transplantation(LT).Although reactivation of CMV infection is generally described in the context of immunosuppression,it has also been described in critically ill immunocompetent patients including cirrhotic patients.AIM To determine the incidence of reactivated CMV prior to LT.METHODS This was a prospective cohort study evaluating adult patients who underwent LT between 2014 and 2016.A plasma sample was obtained from all patients for CMV quantitative real-time PCR testing right before transplantation.Patients were followed for at least 1 year to assess the following outcomes:Incidence of CMV infection,organ rejection and overall mortality.RESULTS A total of 72 patients were enrolled.Four patients died before transplantation,thus 68 patients were followed up for a median of 44 mo(20-50 mo).In 23/72 patients(31.9%)CMV was reactivated before transplantation.Post-transplantation,16/68(23.5%)patients had CMV infection and that was significantly associated with the recipient being CMV negative and a CMV-positive donor.Pretransplant CMV reactivation was not associated with overall mortality(log rank:0.9).CONCLUSION This study shows that CMV infection is common in patients with chronic liver disease just before LT,but the clinical impact of this infection seems to be negligible.
