CYTOMEGALOVIRUS DISEASE AS A RISK FACTOR FOR GRAFT LOSS AND DEATH AFTER ORTHOTOPIC LIVER-TRANSPLANTATION

To determine whether cytomegalovirus (CMV) disease is an independent r isk factor for graft loss and death after orthotopic liver transplanta tion, we performed a 3-year follow-up study of 143 consecutive liver t ransplant recipients and sis patients who underwent retransplantation. Thirty-seven patients (25%) had had CMV disease and were alive after treatment. Fifty-two deaths and eight graft losses occurred. The cumul ative incidence of graft failure at 1 and 3 years of follow-up were 40 % and 63%, respectively, for patients with CMV disease, compared with 22% and 33%, respectively, for those without CMV disease (P <.05, logr ank test), Cumulative probabilities of survival for patients with and without CMV disease were 64% and 82%. respectively, at 1 year and 46% and 69%, respectively, after 3 years (P <.05, logrank test). Multivari ate analysis with use of a time-dependent Cox model showed that previo us CMV disease was an independent risk factor for graft loss at 1 and 3 years of follow-up (P = .04 and P = .007) and for patient survival ( P = .04 and P = .01). Our results indicate that CMV disease is a signi ficant independent risk factor for graft loss and patient survival aft er liver transplantation.