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Digestive Diseases and Sciences

, Volume 37, Issue 5, pp 673–688 | Cite as

Cytomegalovirus infection and disease after liver transplantation

An overview
  • Robert J. Stratta
  • Mark S. Shaeffer
  • Rodney S. Markin
  • R. Patrick Wood
  • Alan N. Langnas
  • Elizabeth C. Reed
  • Jeremiah P. Donovan
  • Gail L. Woods
  • Kathleen A. Bradshaw
  • Todd J. Pillen
  • Byers W. ShawJr.
Review Article

Abstract

Cytomegalovirus is the single most important pathogen in clinical transplantation. Although much progress has been made in our understanding of the molecular biology and epidemiology of CMV infection and in our ability to diagnosis and treat CMV disease, it remains a major cause of morbidity but is no longer a major cause of mortality after liver transplantation. Risk factors for CMV disease after liver transplantation include donor and recipient serologic status, the use of antilymphocyte therapy, and retransplantation. CMV disease occurs early after transplantation, and the most frequent site of disease is the hepatic allograft. We have treated 79 patients with intravenous ganciclovir, with ultimate control of disease achieved in 69 patients (87.3%). Preliminary results using intravenous immunoglobulin and oral acyclovir for CMV prophylaxis in high-risk patients have been encouraging. In addition to producing clinical syndromes, CMV may have direct immunologic effects and is a marker of the net state of immunosuppression.

Key Words

acyclovir cytomegalovirus ganciclovir immunoglobulin immunosuppression liver transplantation OKT3 

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Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • Robert J. Stratta
    • 1
    • 2
    • 3
    • 4
  • Mark S. Shaeffer
    • 1
    • 2
    • 3
    • 4
  • Rodney S. Markin
    • 1
    • 2
    • 3
    • 4
  • R. Patrick Wood
    • 1
    • 2
    • 3
    • 4
  • Alan N. Langnas
    • 1
    • 2
    • 3
    • 4
  • Elizabeth C. Reed
    • 1
    • 2
    • 3
    • 4
  • Jeremiah P. Donovan
    • 1
    • 2
    • 3
    • 4
  • Gail L. Woods
    • 1
    • 2
    • 3
    • 4
  • Kathleen A. Bradshaw
    • 1
    • 2
    • 3
    • 4
  • Todd J. Pillen
    • 1
    • 2
    • 3
    • 4
  • Byers W. ShawJr.
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of SurgeryUniversity of Nebraska Medical CenterOmaha
  2. 2.Department of Pharmacy PracticeUniversity of Nebraska Medical CenterOmaha
  3. 3.Department of Pathology and MicrobiologyUniversity of Nebraska Medical CenterOmaha
  4. 4.Department of Internal MedicineUniversity of Nebraska Medical CenterOmaha

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