Earlier and higher rates of cytomegalovirus infection in pediatric liver transplant recipients as compared to adults: An observational study

Yogita Verma; Ekta Gupta; Niteen Kumar; Nadeem Hasnain; Ajeet Singh Bhadoria; Viniyendra Pamecha; Rajeev Khanna

doi:10.4103/JLP.JLP_140_17

Earlier and higher rates of cytomegalovirus infection in pediatric liver transplant recipients as compared to adults: An observational study

J Lab Physicians. 2018 Apr-Jun;10(2):221-225. doi: 10.4103/JLP.JLP_140_17.

Authors

Yogita Verma¹, Ekta Gupta¹, Niteen Kumar², Nadeem Hasnain¹, Ajeet Singh Bhadoria³, Viniyendra Pamecha², Rajeev Khanna⁴

Affiliations

¹ Department of Clinical virology, Institute of Liver and Biliary Sciences, New Delhi, India.
² Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India.
³ Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
⁴ Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

Abstract

Aim: To study and compare the incidence and time of occurrence of cytomegalovirus (CMV) infection in the posttransplant period in adult and pediatric liver transplant recipients.

Materials and methods: Consecutive live donor liver transplant recipients not on CMV prophylaxis, were prospectively enrolled from March 2012 to September 2015 and followed up for 1 year post transplant to look for CMV infection. For analysis, patients were divided into pediatric (up to 18 years) and adult (>18 years) age groups.

Results: The study population of 146 patients consisted of 132 adult and 14 pediatric patients. Overall CMV infection posttransplant was seen in 54/146 (36.98%) patients, and 16/54 (29.6%) patients developed CMV disease. Post-transplant CMV infection rate was significantly higher in pediatric patients(10/14 [71.4%]) as compared to adults (44/132 [33.4%]) (P = 0.004). Among adults, CMV infection was seen in 22 (50%) patients in the 1^st month, 13 (29.5%) patients in the 2^nd month, 5 (11.4%) patients in the 3^rd month, 2 (4.5%) patients in the 4^th month, and 1 (2.3%) patient each in the 5^th and 6^th month. However, in pediatric patients, all the patients having CMV infection had it in the 1^st-month posttransplant (P = 0.003). The median time of occurrence of CMV infection was 11.5 (7.75-19.00) days in pediatric patients versus 30 (18.5-54.5) days in adult patients (P = 0.001).

Conclusions: The results of this study show a clear difference in the incidence and timeline of posttransplant CMV infection in pediatric patients as compared to adults.

Keywords: Adults; cytomegalovirus infection; liver transplant; pediatric patients.