The Prevention of Cytomegalovirus after Liver Transplantation

Introduction

Cytomegalovirus (CMV) is the single most common viral pathogen, contributing significantly to the morbidity and mortality, after liver transplantation (LT). However, the development of new diagnostic techniques and the knowledge gained through clinical trials involving antiviral therapies for the prevention and treatment of CMV disease have significantly contributed to the management of CMV in the transplant population. This article reviews some of the clinical challenges in the management of CMV after LT with a primary focus on CMV prevention.

Abstract

Cytomegalovirus is a common viral pathogen that can negatively influence the outcome after liver transplantation. The immunocompromised liver transplant population is at an increased risk for developing clinically significant disease. Most cytomegalovirus infections in the liver transplant population are caused by reactivation of latent virus of either donor or recipient origin. Once infected with cytomegalovirus, it can lead to a host of direct effects, which can virtually affect any organ, as well as indirect effects such as an increased predisposition to rejection and opportunistic infections. These direct and indirect effects can lead to increased morbidity and mortality in the transplant recipient. Therefore, cytomegalovirus prevention after liver transplant is an essential component in the management of this population. This review will provide an overview of cytomegalovirus in the liver transplant recipient, while focusing on cytomegalovirus prevention after liver transplantation.

Keywords

CMV, prevention, liver transplant