Stadnik CMB, Caurio CFB, Rodrigues-Filho EM, Nedel WL, Cantisani GP, Zanotelli ML, Pasqualotto AC. Impact of cytomegalovirus reactivation just before liver transplantation: A prospective cohort study. World J Gastrointest Pathophysiol 2021; 12(3): 51-58 [PMID: 34084592 DOI: 10.4291/wjgp.v12.i3.51]
Corresponding Author of This Article
Alessandro C Pasqualotto, MD, PhD, Adjunct Professor, Molecular Biology Laboratory, Santa Casa de Misericordia de Porto Alegre, Av Independência 155, Hospital Dom Vicente Scherer, heliponto, Porto Alegre 90075075, RS, Brazil. pasqualotto@ufcspa.edu.br
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pathophysiol. May 22, 2021; 12(3): 51-58 Published online May 22, 2021. doi: 10.4291/wjgp.v12.i3.51
Impact of cytomegalovirus reactivation just before liver transplantation: A prospective cohort study
Claudio Marcel B Stadnik, Cassia Ferreira B Caurio, Edison M Rodrigues-Filho, Wagner L Nedel, Guido PC Cantisani, Maria L Zanotelli, Alessandro C Pasqualotto
Claudio Marcel B Stadnik, Infection Control Department, Santa Casa de Misericordia de Porto Alegre, Porto Alegre 90075075, RS, Brazil
Cassia Ferreira B Caurio, Alessandro C Pasqualotto, Molecular Biology Laboratory, Santa Casa de Misericordia de Porto Alegre, Porto Alegre 90075075, RS, Brazil
Edison M Rodrigues-Filho, Wagner L Nedel, Intensive Care, Santa Casa de Misericordia de Porto Alegre, Porto Alegre 90075075, RS, Brazil
Guido PC Cantisani, Maria L Zanotelli, Liver Transplant Unit, Santa Casa de Misericordia de Porto Alegre, Porto Alegre 90075075, RS, Brazil
Alessandro C Pasqualotto, Infectious Diseases Unit, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre 90035075, RS, Brazil
Author contributions: Stadnik CMB performed the research, collected and analyzed the data, and wrote the paper; Pasqualotto AC wrote the paper and reviewed of manuscript; Caurio CFB collected data and performed laboratory analyses; Rodrigues-Filho EM, Cantisani GP and Zanotelli ML designed the study and reviewed the manuscript; all authors have read and approved the final manuscript.
Supported byConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)–Brazil, No. 479880/2012-3.
Institutional review board statement: This study was approved by the Research Ethics Committee at Santa Casa de Misericordia of Porto Alegre (294/2010).
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alessandro C Pasqualotto, MD, PhD, Adjunct Professor, Molecular Biology Laboratory, Santa Casa de Misericordia de Porto Alegre, Av Independência 155, Hospital Dom Vicente Scherer, heliponto, Porto Alegre 90075075, RS, Brazil. pasqualotto@ufcspa.edu.br
Received: September 23, 2020 Peer-review started: September 23, 2020 First decision: November 16, 2020 Revised: November 30, 2020 Accepted: February 25, 2021 Article in press: February 25, 2021 Published online: May 22, 2021 Processing time: 232 Days and 12 Hours
Abstract
BACKGROUND
Cytomegalovirus (CMV) is the most common viral pathogen after liver transplantation (LT). Although reactivation of CMV infection is generally described in the context of immunosuppression, it has also been described in critically ill immunocompetent patients including cirrhotic patients.
AIM
To determine the incidence of reactivated CMV prior to LT.
METHODS
This was a prospective cohort study evaluating adult patients who underwent LT between 2014 and 2016. A plasma sample was obtained from all patients for CMV quantitative real-time PCR testing right before transplantation. Patients were followed for at least 1 year to assess the following outcomes: Incidence of CMV infection, organ rejection and overall mortality.
RESULTS
A total of 72 patients were enrolled. Four patients died before transplantation, thus 68 patients were followed up for a median of 44 mo (20-50 mo). In 23/72 patients (31.9%) CMV was reactivated before transplantation. Post-transplantation, 16/68 (23.5%) patients had CMV infection and that was significantly associated with the recipient being CMV negative and a CMV-positive donor. Pre-transplant CMV reactivation was not associated with overall mortality (log rank: 0.9).
CONCLUSION
This study shows that CMV infection is common in patients with chronic liver disease just before LT, but the clinical impact of this infection seems to be negligible.
Core Tip: Cytomegalovirus (CMV) commonly reactivates before liver transplantation in patients with chronic liver conditions. This prospective cohort study demonstrates for the first time that although frequent, CMV reactivation has limited clinical impact when occurring just before liver transplantation.
