title: The effect of donor-recipient cytomegalovirus serology on adult liver transplantation: a single center experience.
abstract: BACKGROUND
  We investigated the outcomes of adult liver transplants, according to their donor-recipient cytomegalovirus (CMV) serology.
  
  
  METHODS
  We included in the study all adult primary liver transplants, from January 1, 2002, to December 31, 2005. Follow-up was until December 31, 2007. According to the donor-recipient CMV serology, patients were divided into positive-negative (PN), positive-positive, negative-negative, and negative-positive groups, and all received CMV prophylaxis for 4 months posttransplantation. Hepatitis C patients received conventional immunosuppression, whereas all other patients received either conventional treatment or alemtuzumab (Campath-1H) induction.
  
  
  RESULTS
  We studied 438 adult liver transplants. Comparisons were made between high-risk group patients (PN) versus all others: 5-year patient survival was 74.31% vs. 78.8%, (P=NS) and graft survival 63.87% vs. 74.77%, (P=0.042). Five-year freedom from rejection was 42.84% vs. 51.95% (P=0.036). CMV infection (n=3) or disease (n=27) was observed in 30 patients (PN [n=23], positive-positive [n=6], and negative-positive [n=1]). Incidence of CMV infection was 9.8% overall and 34.84% and 2.5%, respectively, for the PN group versus all others (P=0.0000). Patients who received Campath-1H induction did not have an increased incidence of CMV infections compared with those who received conventional immunosuppression.
  
  
  CONCLUSIONS
  In our center, in adult liver transplantation, CMV donor-recipient PN serology is associated with rejection, graft survival, and CMV infection but is not correlated with patient survival, Epstein-Barr virus (EBV) occurrence, or viral hepatitis recurrence. The introduction of more potent induction immunosuppression did not accentuate these negative outcomes.
authors.affiliation: Division of Transplantation, Department of Surgery, University of Miami School of Medicine, Miami, FL 33136, USA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tryphonopoulos
authors.forename: Debbie
authors.initials: D
authors.lastname: Weppler
authors.forename: Michele I
authors.initials: MI
authors.lastname: Morris
authors.forename: Cristina
authors.initials: C
authors.lastname: Russo
authors.forename: Seigo
authors.initials: S
authors.lastname: Nishida
authors.forename: David M
authors.initials: DM
authors.lastname: Levi
authors.forename: Jang
authors.initials: J
authors.lastname: Moon
authors.forename: Akin
authors.initials: A
authors.lastname: Tekin
authors.forename: Gennaro
authors.initials: G
authors.lastname: Selvaggi
authors.forename: Eddie
authors.initials: E
authors.lastname: Island
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Arosemena
authors.forename: Phillip
authors.initials: P
authors.lastname: Ruiz
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Tzakis
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D016031:Liver Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D055502:Secondary Prevention; D014019:Tissue Donors; D014180:Transplantation
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D007166:Immunosuppressive Agents