Management of cytomegalovirus infection and disease in liver transplant recipients

Table 3 Actors associated with increased risk of cytomegalovirus disease after liver transplantation

CMV D+/R- > CMV R+

Allograft rejection

High viral replication

Mycophenolate mofetil

Anti-thymocyte globulin

Alemtuzumab

Human herpesvirus-6

Human herpesvirus-7

Renal insufficiency

Deficiency in CMV-specific CD4+ T cells

Deficiency in CMV-specific CD8+ T cells

Toll-like receptor gene polymorphism

Mannose binding lectin deficiency

Chemokine and cytokine defects (IL-10, MCP-1, CCR5)

Expression of immune evasion genes

Programmed cell death 1 expression

Others1

¹Others include re-transplantation, volume of blood transfusion, sepsis and other factors associated with high tumor necrosis factor-α secretion. D: Donor; R: Recipient; IL-10: Interleukin-10; MCP-1: Monocyte chemotactic protein-1; CCR5: Chemokine (C-C motif) receptor 5; CMV: Cytomegalovirus.