title: Risk factors of cytomegalovirus infection after pediatric liver transplantation.
abstract: OBJECTIVE
  Cytomegalovirus (CMV) infection is known to be the most frequently viral infection among patients after liver transplantation. This is especially true in pediatric living-donor liver transplantation because the recipients have often not been infected with CMV and postoperative primary infection with CMV frequently occurs.
  
  
  METHODS
  Of 93 patients who underwent pediatric liver transplantation at our department, 33 patients (36.3%) were diagnosed with CMV infection using the antigenemia method (C7-HRP). Retrospective review and statistical analysis were conducted to confirm risk factors of post-transplantation CMV infection.
  
  
  RESULTS
  Positive lymphocytes were diagnosed between postoperative days 8 and 111 after transplantation. Ganciclovir or foscavir were administrated to 21 patients. The other 10 patients who had one positive lymphocyte were observed and the cell disappeared on follow-up examination. We did not observe any cases of positive lymphocytes with C7-HRP in patients who received a graft from a CMV antibody-negative donor. Independent predictors associated with CMV infection in the multivariable analysis were administration of OKT3 and grafts from CMV antibody-positive donors.
  
  
  CONCLUSIONS
  In CMV infection after pediatric liver transplantation, cases with CMV antibody-positive donors and with OKT3 administration for acute rejection are considered high risk, and cases with CMV antibody-negative donors are considered low risk.
authors.affiliation: Department of Surgery, Nippon Medical School, Tokyo, Japan. Electronic address: y-kawano@nms.ac.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Kawano
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mizuta
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sanada
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Urahashi
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ihara
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Okada
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yamada
authors.affiliation: Department of Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sasanuma
authors.affiliation: Department of Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sakuma
authors.affiliation: Department of Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Taniai
authors.affiliation: Department of Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kawarasaki
authors.affiliation: Department of Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Department of Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Uchida
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral