Cytomegalovirus infection in liver transplant recipients: Updates on clinical management

Table 1 Direct and indirect clinical effects of cytomegalovirus in transplant recipients

Direct clinical effects	Indirect clinical effects
CMV syndrome	Acute allograft rejection
Fever > 38  °C for 2/4 d	Chronic allograft rejection
Malaise	Allograft failure
Myelosuppression	Vanishing duct syndrome/ductopenia
Tissue-invasive CMV disease1 Gastrointestinal disease (entire gastrointestinal tract can be affected)	Allograft hepatitis and fibrosis
	Vascular thrombosis
	Opportunistic and other infections
	Hepatitis	Fungal (Aspergillus, Pneumocystis)
Pneumonitis	Bacterial (Nocardia)
Retinitis	Viral (HHV-6, HHV-7, EBV)
CNS disease	Hepatitis C virus recurrence
Carditis	EBV associated PTLD
Mortality	Mortality

¹Can affect any organ, listed are most common organs affected. PTLD: Post-transplant lymphoproliferative disorder; HHV: Human herpes virus; EBV: Epstein-Barr virus; CMV: Cytomegalovirus.