title: Effect of antiviral chemoprophylaxis on adverse clinical outcomes associated with cytomegalovirus after liver transplantation.
abstract: OBJECTIVE
  To assess t he association be tweencytomegalovirus (CMV) serology of donor and recipient and adverse outcomes afterliver transplantation in the era of effective antiviral chemoprophylaxis.
  
  
  METHODS
  We performed a retrospective cohort study of 193 consecutive patients undergoing their first liver transplantation between February 1998 and July 2000 with targeted and preemptive ganciclovir chemoprophylaxis. Patients were divided into 4 groups by CMV serology of donor and recipient: donor-/recipient-; donor-/recipient+; donor+/recipient+; and donor+/recipient-. Survival to the end points of retransplantation, death, or survival to 1 year after transplantation (whichever occurred first) was assessed. Rates of bacterial, fungal, and CMV Infection and of CMV disease were recorded and compared.
  
  
  RESULTS
  No significant differences were observed in the rates of retransplantation, death, or survival to 1 year among the 4 groups of patients. Despite significantly higher rates of CMV infection in the donor+ groups, there were no differences in the rates of bacterial or fungal Infection or of CMV disease. Rejection occurred least frequently in the donor-/recipient- group.
  
  
  CONCLUSIONS
  The adverse effects of CMV on outcomes after liver transplantation have been diminished in the era of effective antiviral chemoprophylaxis.
authors.affiliation: Division of Infectious Diseases, Mayo Clinic College of Medicine, 4500 San Pablo Rd, Jacksonville, FL 32224, USA. helling@mayo.edu
authors.forename: Walter C
authors.initials: WC
authors.lastname: Hellinger
authors.forename: Hugo
authors.initials: H
authors.lastname: Bonatti
authors.forename: Victor I
authors.initials: VI
authors.lastname: Machicao
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Yao
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Brumble
authors.forename: Salvador
authors.initials: S
authors.lastname: Alvarez
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Weigand
authors.forename: Rolland C
authors.initials: RC
authors.lastname: Dickson
authors.forename: Denise M
authors.initials: DM
authors.lastname: Harnois
authors.forename: James R
authors.initials: JR
authors.lastname: Spivey
authors.forename: Wolf H
authors.initials: WH
authors.lastname: Stapelfeldt
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Hughes
authors.forename: Justin H
authors.initials: JH
authors.lastname: Nguyen
authors.forename: Jeffery L
authors.initials: JL
authors.lastname: Steers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use*; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents