Intraoperative hypothermia is an independent risk factor for early cytomegalovirus infection in liver transplant recipients

Background. Early cytomegalovirus (CMV) reactivation infections have been f ound to be associated with a number of stress responses such as severe bact erial infection. Intraoperative hypothermia is known to be a significant ph ysiological stressor. Hence, we sought to evaluate a relationship between i ntraoperative hypothermia during liver transplantation and early CMV infect ion. Methods. Relationships between intraoperative hypothermia and early CMV inf ection were assessed using univariate and multivariate analysis. Results. There were 11 of 100 patients who had CMV infection detected withi n the first 30 days after the transplant and 16 of 100 in the next 3 months after the transplant. The median intraoperative temperature (34.4 degrees C) of those who subsequently developed early CMV infection was significantl y lower than that in patients who did not develop early CMV infection (35.3 degrees C; P=0.032). Multivariate analysis showed that only hypothermia wa s an independent predictor of early CMV infection (odds ratio 2.8, 95% conf idence intervals 1.2-6.4; P=0.047). Conclusions. Intraoperative hypothermia during liver transplantation increa ses the risk of CMV infection in the 1st month postoperatively and active w arming seems to reduce this risk.