Cytomegalovirus infection in living donor liver transplant recipients significantly impacts the early post-transplant outcome: A single center experience

Transpl Infect Dis. 2018 Aug;20(4):e12905. doi: 10.1111/tid.12905. Epub 2018 May 24.


Background: Cytomegalovirus (CMV) is the most common viral infection in liver transplant recipients that influences the outcomes of liver transplantation. However, its impact on early outcomes following living donor liver transplantation (LDLT) is not fully defined in the Indian subcontinent. This study was done to assess the impact of CMV infection on early post-transplant outcomes in LDLT recipients.

Methods: Out of 272 LDLTs performed from January 2012 to April 2013, 151 recipients underwent CMV viral load analysis in plasma within 90 days post LDLT based on clinical suspicion. Patients with CMV infection (n = 55) were compared with those without CMV infection (n = 96).

Results: The median time interval of CMV infection from LDLT was 25 days (range 2-90 days). The mean age of study population was 48.92 years. About 116 (76.8%) of the patients were male. Hepatitis C virus (HCV) (39.1%)-related chronic liver disease (CLD) was most common indication for liver transplant. No statistically significant difference was observed in etiology of liver disease (P = .38), Chid-Turcotte-Pugh (CTP) (P = .41), and Model for End-stage Liver Disease (MELD) (P = .12) scores between the groups. Patients with CMV infection had significantly higher incidence of acute cellular rejection (16.1% vs 5.4%, P = .02); longer ICU stay (P = .01); and a higher overall 90-day mortality (24.2% vs 6.7%, P = .001). Bacteremia and fungemia were significantly more common in the CMV infection group.

Conclusion: Cytomegalovirus infection significantly influences the early post LDLT outcomes and contributes to increased overall mortality.

Keywords: CMV infection; acute cellular rejection; liver; living donor; transplantation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antibiotic Prophylaxis / methods
  • Antiviral Agents / therapeutic use
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / epidemiology*
  • Cytomegalovirus Infections / immunology
  • Cytomegalovirus Infections / prevention & control
  • Cytomegalovirus Infections / virology
  • End Stage Liver Disease / diagnosis
  • End Stage Liver Disease / surgery
  • Female
  • Follow-Up Studies
  • Graft Rejection / epidemiology*
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control
  • Graft Rejection / virology
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Incidence
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Living Donors
  • Male
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome


  • Antiviral Agents
  • Immunosuppressive Agents