Demonstration of cytomegalovirus by polymerase chain reaction after liver transplantation

Transplantation. 1993 Oct;56(4):872-4. doi: 10.1097/00007890-199310000-00019.

Abstract

The polymerase chain reaction (PCR) is a highly sensitive and specific technique for detection of cytomegalovirus DNA. With this method we prospectively analyzed buffy coat leukocytes at weekly intervals over 3 months in 60 patients after liver transplantation (LTX). The PCR results were correlated with the pretransplant donor/recipient CMV antibody status and with the occurrence of CMV-induced disease. Thirty-three of 60 (55%) patients became PCR-positive during their posttransplant course. None of the 27 patients with permanent negative PCRs developed CMV disease. Of 33 patients with positive PCRs, 13 (39%) became ill. CMV disease developed in 9 of 22 (41%) antibody-negative recipients but only in 4 of 38 (10%) seropositive graft recipients. The incidence of CMV disease was 75% (9 of 12 patients) in seronegative recipients who converted to positive PCR results and 19% (4 of 21 patients) in seropositive patients with positive PCR findings. The predictive value of a positive PCR was 75% in seronegative patients but it was low (19%) in seropositive recipients. The predictive value of a negative PCR is 100%. Thus, PCR determinations are useful in identifying patients who will not develop CMV disease and in narrowing down the number of individuals who will become sick. Further, PCR is a helpful tool in the follow-up of patients under antiviral treatment.

MeSH terms

  • Adult
  • Antibodies, Viral / blood
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / diagnosis*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Leukocyte Count
  • Leukocytes / microbiology
  • Liver Transplantation* / physiology
  • Male
  • Middle Aged
  • Platelet Count
  • Polymerase Chain Reaction / methods*
  • Postoperative Complications / blood
  • Postoperative Complications / diagnosis

Substances

  • Antibodies, Viral