Cytomegalovirus and Death in Liver Transplantation

Nina Singh; Timothy Gayowski

doi:10.7326/0003-4819-127-5-199709010-00020

Letters |1 September 1997

Cytomegalovirus and Death in Liver Transplantation

Nina Singh, MD; Timothy Gayowski, MD

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TO THE EDITOR:

Falagas and colleagues [1] concluded that the cytomegalovirus (CMV) serologic status of liver transplant donors and recipients was a significant determinant of death in the recipients. Our experience differs substantially from theirs. In our program, 130 patients have undergone orthotopic liver transplantation under tacrolimus-based primary immunosuppression in the 1990s. Neither CMV infection nor disease were predictors of death in our patients [2], and no correlation between the CMV serostatus of recipients and donors and death was seen (Table 1).

The major difference in mortality rates, as shown in the Table 1, might be explained by the fact that Falagas and colleagues' study was done in the late 1980s, before the introduction of tacrolimus and the routine availability of ganciclovir. Tacrolimus-based immunosuppression has been associated with slightly improved survival [3] and a lower incidence of CMV infection after liver transplantation [3, 4]. The introduction of ganciclovir has led to a marked decrease in CMV-associated mortality in transplant recipients. It should be noted. however, that Stratta and colleagues [5] also saw no correlation between CMV serologic status and patient survival in a study of 211 liver transplant recipients who underwent transplantation between 1985 and 1989.

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Letters |1 September 1997

Cytomegalovirus and Death in Liver Transplantation

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Letters |1 September 1997

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