Current concepts on cytomegalovirus infection after liver transplantation

Table 1 Direct and indirect clinical effects of cytomegalovirus after solid organ transplantation

Direct effects	Indirect effects
CMV syndrome	Acute allograft rejection
Fever
Myelosuppression
Malaise
Tissue-invasive CMV disease1	Chronic allograft rejection
Gastrointestinal disease (colitis, esophagitis, gastritis, enteritis)	Vanishing bile duct syndrome Chronic ductopenic rejection
Hepatitis	Hepatitis C virus recurrence
Pneumonitis	Allograft hepatitis, fibrosis and allograft failure
CNS disease
Retinitis
Mortality	Opportunistic and other infections
	Fungal superinfection
	Nocardiosis
	Bacterial superinfection
	Epstein-Barr virus and PTLD
	HHV-6 and HHV-7 infections
	Vascular thrombosis
	Mortality

PTLD: post-transplant lymphoproliferative disease; HHV: human herpes virus; CMV: cytomegalovirus.

¹Any organ system may be affected by CMV.