OKT3 TREATMENT FOR ALLOGRAFT-REJECTION IS A RISK FACTOR FOR CYTOMEGALOVIRUS DISEASE IN LIVER-TRANSPLANTATION

The role of OKT3 monoclonal antibody administration was studied as a r isk factor for symptomatic cytomegalovirus (CMV) infection in 229 cons ecutive liver transplant recipients not receiving specific CMV prophyl axis. Twenty-six patients (11.4%) received OKT3 and 17 of them develop ed CMV infection, 11 (4.8%) being symptomatic, OKT3 use was a signific ant risk factor for symptomatic CMV infection by both univariate (rela tive risk [RR], 2.9; 95% confidence interval [CI], 1.5-5.8; P = .002) and multivariate time-dependent (RR, 3.4; 95% Ct, 1.7-7.1; P = .001) a nalyses, A subgroup analysis revealed that OKT3 use was a significant risk factor for symptomatic CMV infection in CMV-seropositive but not seronegative recipients, OKT3 therapy for steroid-resistant rejection is a risk factor for symptomatic CMV infection in liver transplant rec ipients who are seropositive for CMV before transplantation. This grou p should be targeted for antiviral prophylaxis when OKT3 antirejection therapy is used.