Clinical Patterns of Cytomegalovirus Disease After Liver Transplantation

Intrahepatic cholestasis after liver transplantation

“…[55][56][57] Overall, it develops in 30% to 50% of liver transplant recipients. Approximately half of these cases are associated with symptomatic CMV disease.…”

Management of cytomegalovirus infection after liver transplantation

“…Recurrent CMV disease occurs at a rate of 26% to 31% after OLT. 4 Primary CMV disease, 5,6 antirejection therapy, 7 initial episodes of multiorgan CMV disease, and CMV pneumonia 4 have been shown to be risk factors for recurrent CMV disease. Mortality is greater in patients with recurrent disease.…”

“…28 Steroids as monotherapy have a minimal effect on reactivation of latent CMV in vivo; however, when high doses are used, a greater incidence and increased severity of CMV disease has been observed, most likely by decreasing cellular immune function. 29 Mycophenolate mofetil has dramatically reduced the incidence of acute allograft rejection in renal transplant Rejection and antirejection therapy 5,11,22 Fulminant hepatic failure 22,26 Hepatic artery thrombosis 11 HHV-6 and HHV-7 infections 36,76 Hepatitis C infection 77 recipients, and this has been associated with an increase in the frequency and severity of CMV invasive disease. [30][31][32] Last, the conventional antilymphocyte preparations (OKT3 and antilymphocyte globulin, among others) not only increase CMV replication by suppressing the immune system, but most importantly, by directly reactivating latent CMV by means of the activation of transcription factors.…”

Hepatobiliary Quiz Answers—17 (2016)

“…It is usually seen 1 to 4 months post transplant. [52][53][54][55] Half of these cases will have symptomatic CMV disease. Patients present with fever and jaundice, and liver function tests show a cholestatic pattern.…”