The effect of sirolimus-based immunosuppression vs. conventional prophylaxis therapy on cytomegalovirus infection after liver transplantation.

OBJECTIVE

The aim of this study was to assess the efficacy of sirolimus-based immunosuppression vs. conventional prophylaxis therapy in preventing cytomegalovirus (CMV) infection or disease in liver transplantation recipients.

METHODS

One hundred and twenty-seven consecutive liver transplant recipients, with a minimum of one-yr follow-up from 2008 to 2013 in the first affiliated hospital of Nanchang University, were retrospectively divided into the sirolimus-treated (n = 51) and ganciclovir-treated (n = 76) groups. The CMV incidence, rejection events, and survival rate were compared.

RESULTS

The overall incidences of CMV events were decreased but did not reach statistical significance in the sirolimus arm compared with the ganciclovir arm (p > 0.05) at one yr after liver transplantation. There was no significant difference in the rejection incidence and survival rates between the two groups.

CONCLUSIONS

Sirolimus-based immunosuppression had a lower incidence of CMV infection compared with conventional prophylaxis therapy and did not increase rejection risks and mortality after liver transplantation, indicating that with the use of an mammalian target-of-rapamycin (mTOR)-inhibitor, CMV prophylaxis may be dispensable.