Cytomegalovirus disease after liver transplantation: a nationwide population-based study.
BACKGROUND
Cytomegalovirus (CMV) disease is a significant complication after liver transplantation. The estimated incidence varies among studies, which have been conducted in single regional centers and with small cohorts. In this study, we investigated the occurrence of CMV disease among liver transplant recipients in a national cohort in Taiwan.


METHODS
This retrospective study used data from the Taiwan National Health Insurance Research Database. All liver transplant recipients in the catastrophic illness database from 2000 to 2009 were enrolled. Cases of CMV disease were identified from the admission database with the use of the ICD-9-CM code 078.


RESULTS
The national cohort consisted of 1,721 liver transplant recipients (1,200 men and 521 women) with a mean age of 43.9 ± 8.9 years at the time of transplantation. The mean follow-up duration was 3.6 ± 2.7 years. The mortality rate was 14.9% at 1 year and 20.5% at 5 years. During the study period, 84 patients (4.9%) were diagnosed with CMV disease. The overall prevalence of CMV disease was 14.5 per 100 person-years. The cumulative incidences of post-transplantation CMV infection at 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years were 1.2%, 2.7%, 3.8%, 4.2%, 4.8%, and 4.9%, respectively. The most common CMV-related diseases were colitis, hepatitis, and pneumonia.


CONCLUSIONS
The risk of CMV disease was significantly elevated in the first 6 months after liver transplantation in the Taiwanese cohort.
Division of Infection, Liver Transplantation Center, Taichung Veterans General Hospital, Taiwan; College of Veterinary Medicine, National Chung Hsing University, Taiwan; Department of Pharmacy, Tajen University, Taiwan.
P-Y
PY
Liu
Department of Surgery, Taichung Veterans General Hospital, Taiwan.
S-B
SB
Cheng
Department of Pediatrics, Taichung Veterans General Hospital, Taiwan.
C-C
CC
Lin
Department of Medical Research, Taichung Veterans General Hospital, Taiwan.
C-H
CH
Lin
Department of Medical Research, Taichung Veterans General Hospital, Taiwan.
S-N
SN
Chang
Department of Pharmacy, Taichung Veterans General Hospital, Taiwan.
C-Y
CY
Cheng
Division of Infection, Liver Transplantation Center, Taichung Veterans General Hospital, Taiwan.
Z-Y
ZY
Shi
College of Veterinary Medicine, National Chung Hsing University, Taiwan.
K-C
KC
Tung
Division of Nephrology, Taichung Veterans General Hospital, Taiwan; School of Medicine, Chung Shan Medical University, Taiwan; Graduate Institute of Clinical Medical Science, School of Medicine, China Medical University, Taiwan; Institute of Biomedical Science and Rong Hsing Research Center for Translation Medicine, National Chung Hsing University, Taiwan; Department of Life Science, Tunghai University, Taiwan. Electronic address: wmj530@gmail.com.
M-J
MJ
Wu
D000328:Adult; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000209:etiology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013624:Taiwan