Donated organ as a source of cytomegalovirus in orthotopic liver transplantation

Abstract

The importance of the donated organ as a source of CMV was assessed in 120 patients following orthotopic liver transplant and the CMV infections that developed in these patients were graded by severity. Forty‐four recipients were CMV antibody negative pre‐transplant. Eighteen of these received organs from CMV antibody positive donors and 15 (83%) developed primary CMV infections, 13 (87%) of which were symptomatic. Twenty‐six received organs from CMV antibody negative donors and only 2 (8%) became CMV positive post transplant (P < 0.001). These data suggest that there would be a considerable advantage in matching CMV antibody negative recipients with negative donors. Forty‐five percent of secondary infections were asymptomatic compared with 12% of primary infections, and only 11% became disseminated compared with 53% of primary infections. The secondary infections that followed transplantation of an organ from a CMV antibody positive donor were more likely to be symptomatic and were more severe than those in patients who received seronegative livers.