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

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%]) ( = 0.004). Among adults, CMV infection was seen in 22 (50%) patients in the 1 month, 13 (29.5%) patients in the 2 month, 5 (11.4%) patients in the 3 month, 2 (4.5%) patients in the 4 month, and 1 (2.3%) patient each in the 5 and 6 month. However, in pediatric patients, all the patients having CMV infection had it in the 1-month posttransplant ( = 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 ( = 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.