Incidence and risk factors of cytomegalovirus infection after living donor liver transplantation…A single center study

Abstract

Liver transplantation is one of the most effective therapeutic options for patients with acute and chronic end stage liver diseases who have failed standard therapy. Infections remain a major cause of morbidity and mortality after liver transplantation. Cytomegalovirus (CMV) infection is the most common viral pathogen that influences the outcome of liver transplantation. The aim of this study was to determine the incidence and risk factors of CMV infection after LDLT at Ain Shams specialized hospital in Egypt. One hundred, and five (105) patients underwent LDLT in our center between January 2010 till December 2013. CMV PCR was done for all patients at the 1st month post-transplant, and whenever clinically suspected during the first 6 months. According to CMV infection, the patients were classified into 2 groups: {group I CMV positive (28 patients) and group II CMV negative (77 patients)}. Incidence of CMV infection was calculated and several pre-transplant and post-transplant factors were analyzed to clarify risk factors for CMV infection. Analysis of our results revealed that the incidence of CMV infection was 26.6% with 56% of cases occurring during the 1st month, followed by 30% in the 2nd month, 7% in the 3rd and 6th months respectively. The median time of occurrence of CMV infection was the 1st month. Upon conducting multivariate analysis; re-operation, hyponatremia, prolonged ICU stay post-operative (≥ 5days) and mycophenolate sodium (myfortic) immunosuppressive use were significant risk factors that increase the probability of CMV occurrence.