title: Cytomegalovirus disease as a risk factor for graft loss and death after orthotopic liver transplantation.
abstract: To determine whether cytomegalovirus (CMV) disease is an independent risk factor for graft loss and death after orthotopic liver transplantation, we performed a 3-year follow-up study of 143 consecutive liver transplant recipients and six patients who underwent retransplantation. Thirty-seven patients (25%) had had CMV disease and were alive after treatment. Fifty-two deaths and eight graft losses occurred. The cumulative incidence of graft failure at 1 and 3 years of follow-up were 40% and 63%, respectively, for patients with CMV disease, compared with 22% and 33%, respectively, for those without CMV disease (P < .05, logrank test). Cumulative probabilities of survival for patients with and without CMV disease were 64% and 82%, respectively, at 1 year and 46% and 69%, respectively, after 3 years (P < .05, logrank test). Multivariate analysis with use of a time-dependent Cox model showed that previous CMV disease was an independent risk factor for graft loss at 1 and 3 years of follow-up (P = .04 and P = .007) and for patient survival (P = .04 and P = .01). Our results indicate that CMV disease is a significant independent risk factor for graft loss and patient survival after liver transplantation.
authors.affiliation: Infectious Diseases Service, Hospitals Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: de Otero
authors.forename: J
authors.initials: J
authors.lastname: Gavaldà
authors.forename: E
authors.initials: E
authors.lastname: Murio
authors.forename: V
authors.initials: V
authors.lastname: Vargas
authors.forename: I
authors.initials: I
authors.lastname: Calicó
authors.forename: L
authors.initials: L
authors.lastname: Llopart
authors.forename: J
authors.initials: J
authors.lastname: Rosselló
authors.forename: C
authors.initials: C
authors.lastname: Margarit
authors.forename: A
authors.initials: A
authors.lastname: Pahissa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003586:Cytomegalovirus Infections; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors