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A short-term preemptive treatment for cytomegalovirus infection in seropositive patients after liver transplantation

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background/purpose

Cytomegalovirus (CMV) infection remains a challenge following liver transplantation. Preemptive treatment is an effective strategy for CMV infection. However, how long preemptive treatment should be applied is not defined.

Methods

Clinical records of preemptive treatment for CMV infection in patients who underwent liver transplantation were collected. CMV antigenemia (pp65) was monitored weekly during hospital stay and subsequently on follow up whenever indicated clinically. Antiviral treatment was administered based on positive antigenemia (>1 positive cell per 500,000 leukocytes) and discontinued when antigenemia became negative.

Results

CMV infection was diagnosed in 58 (43.9%) of 132 liver transplantation patients. All 58 patients were seropositive for CMV before transplantation. CMV infection was first diagnosed at a median time of 20 days (interquartile range [IQR] 15.3–26) after transplantation. Twelve (20.7%) patients developed repeated infections. Only one of 58 patients (1.7%) was suspected to have invasive disease. The median (IQR) duration of antiviral treatment was 7 (7–12) days. Of these patients with CMV infection, 14 (24.1%) patients developed acute rejection peri-anti-CMV treatment and 36 (62.1%) developed other infectious complications.

Conclusion

Preemptive treatment is an effective way to halt the progression of asymptomatic CMV infection. A brief course of antiviral treatment is enough for seropositive patients with CMV infection after liver transplantation.

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Authors and Affiliations

  1. Department of Liver and Transplantation Surgery, Chang-Gung Transplantation Institute, Chang-Gung Memorial Hospital, Chang-Gung University Medical School, Taoyuan, Taiwan

    Divya Dahiya, Chen-Fang Lee, Kun-Ming Chan, Ting-Jung Wu, Hong-Shiue Chou, Shin-Shin Cheng & Wei-Chen Lee

  2. Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University Medical School, 5, Fu-Shing Street, Kwei-Shan, Taoyuan, 333, Taiwan

    Wei-Chen Lee

Authors
  1. Divya Dahiya
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  2. Chen-Fang Lee
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  3. Kun-Ming Chan
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  4. Ting-Jung Wu
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  5. Hong-Shiue Chou
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  6. Shin-Shin Cheng
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  7. Wei-Chen Lee
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Corresponding author

Correspondence to Wei-Chen Lee.

Additional information

D. Dahiya and C.-F. Lee contributed equally to this study.

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Dahiya, D., Lee, CF., Chan, KM. et al. A short-term preemptive treatment for cytomegalovirus infection in seropositive patients after liver transplantation. J Hepatobiliary Pancreat Sci 18, 32–38 (2011). https://doi.org/10.1007/s00534-010-0286-0

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  • DOI: https://doi.org/10.1007/s00534-010-0286-0

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