Donated organ as a source of cytomegalovirus in orthotopic liver transplantation.
The importance of the donated organ as a source of CMV was assessed in 120 patients following orthotopic liver transplant and the CMV infections that developed in these patients were graded by severity. Forty-four recipients were CMV antibody negative pre-transplant. Eighteen of these received organs from CMV antibody positive donors and 15 (83%) developed primary CMV infections, 13 (87%) of which were symptomatic. Twenty-six received organs from CMV antibody negative donors and only 2 (8%) became CMV positive post transplant (P less than 0.001). These data suggest that there would be a considerable advantage in matching CMV antibody negative recipients with negative donors. Forty-five percent of secondary infections were asymptomatic compared with 12% of primary infections, and only 11% became disseminated compared with 53% of primary infections. The secondary infections that followed transplantation of an organ from a CMV antibody positive donor were more likely to be symptomatic and were more severe than those in patients who received seronegative livers.
Sutherland
S
S
Virology Laboratory, Dulwich Hospital, London, England.
Bracken
P
P
Wreghitt
T G
TG
O'Grady
J
J
Calne
R Y
RY
Williams
R
R
D000914:Antibodies, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D012307:Risk Factors; D014019:Tissue Donors
D000914:Antibodies, Viral