Demonstration of cytomegalovirus by polymerase chain reaction after liver transplantation.
The polymerase chain reaction (PCR) is a highly sensitive and specific technique for detection of cytomegalovirus DNA. With this method we prospectively analyzed buffy coat leukocytes at weekly intervals over 3 months in 60 patients after liver transplantation (LTX). The PCR results were correlated with the pretransplant donor/recipient CMV antibody status and with the occurrence of CMV-induced disease. Thirty-three of 60 (55%) patients became PCR-positive during their posttransplant course. None of the 27 patients with permanent negative PCRs developed CMV disease. Of 33 patients with positive PCRs, 13 (39%) became ill. CMV disease developed in 9 of 22 (41%) antibody-negative recipients but only in 4 of 38 (10%) seropositive graft recipients. The incidence of CMV disease was 75% (9 of 12 patients) in seronegative recipients who converted to positive PCR results and 19% (4 of 21 patients) in seropositive patients with positive PCR findings. The predictive value of a positive PCR was 75% in seronegative patients but it was low (19%) in seropositive recipients. The predictive value of a negative PCR is 100%. Thus, PCR determinations are useful in identifying patients who will not develop CMV disease and in narrowing down the number of individuals who will become sick. Further, PCR is a helpful tool in the follow-up of patients under antiviral treatment.
Schmidt
C A
CA
Abteilung für Innere Medizin und Poliklinik, Universitätsklinikum Rudolf Virchow, Freie Universität Berlin, Germany.
Oettle
H
H
Neuhaus
P
P
Wiens
M
M
Timm
H
H
Wilborn
F
F
Siegert
W
W
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes / Q000382:microbiology; D016031:Liver Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D016133:Polymerase Chain Reaction / Q000379:methods*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis
D000914:Antibodies, Viral