{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:36:15Z","timestamp":1791826575528,"version":"4.3.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Among solid organ transplant recipients, donor cytomegalovirus (CMV) seropositive (D+) and recipient seronegative (R\u2212) status are associated with an increased risk of graft loss and mortality after kidney or lung transplantation. Whether a similar relationship exists among liver transplant recipients (LTR) is unknown. We assessed graft loss and mortality among adult LTRs from January 1, 2010, to March 14, 2020, in the Organ Procurement and Transplantation Network database. We used multivariable mixed Cox proportional hazards regression to analyze the association of donor and recipient CMV serostatus group with graft loss and mortality, with donor seronegative (D\u2212) and recipient seronegative (R\u2212) as the reference group. Among 54,078 LTRs, the proportion of D\u2212R\u2212, D\u2212 and recipient seropositive (R+), D+R\u2212, and D+R+ was 13.4%, 22.5%, 22%, and 42%, respectively. By unadjusted Kaplan\u2010Meier survival curve estimates, survival by the end of follow\u2010up was 73.3%, 73.5%, 70.1%, and 69.7%, among the D\u2212R\u2212, D\u2212R+, D+R\u2212, and D+R+ groups, respectively. By multivariable Cox regression, the CMV D+R\u2212 serogroup, but not other serogroups, was independently associated with increased risks of graft loss (adjusted hazard ratio [aHR], 1.13; 95% confidence interval [CI], 1.05\u20101.22) and mortality (aHR, 1.13; 95% CI, 1.05\u20101.22). The magnitude of the association of the CMV D+R\u2212 serostatus group with mortality was similar when the Cox regression analysis was restricted to the first year after transplant and beyond the first year after transplant: aHR, 1.13 (95% CI, 1.01\u20101.27) and aHR, 1.13 (95% CI, 1.02\u20101.25), respectively. Even in an era of CMV preventive strategies, CMV D+R\u2212 serogroup status remains independently associated with increased graft loss and mortality in adult LTRs. Factors in addition to direct CMV\u2010associated short\u2010term mortality are likely, and studies to define the underlying mechanism(s) are warranted.<\/jats:p>","DOI":"10.1002\/lt.26045","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T10:48:31Z","timestamp":1615286911000},"page":"1302-1311","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":18,"title":["Association of Donor and Recipient Cytomegalovirus Serostatus on Graft and Patient Survival in Liver Transplant Recipients"],"prefix":"10.1097","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4196-6077","authenticated-orcid":false,"given":"Philip","family":"Vutien","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Center for Liver Investigation Fostering discovEry (C\u2010LIFE),University of Washington,Seattle,WA"},{"name":"Division of Transplant Surgery,Clinical and Bio\u2010Analytics Transplant Laboratory,University of Washington,Seattle,WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Perkins","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,Clinical and Bio\u2010Analytics Transplant Laboratory,University of Washington,Seattle,WA"},{"name":"Division of Transplant Surgery,University of Washington,Seattle,WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott W.","family":"Biggins","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Center for Liver Investigation Fostering discovEry (C\u2010LIFE),University of Washington,Seattle,WA"},{"name":"Division of Transplant Surgery,Clinical and Bio\u2010Analytics Transplant Laboratory,University of Washington,Seattle,WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3065-8674","authenticated-orcid":false,"given":"Jorge","family":"Reyes","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,Clinical and Bio\u2010Analytics Transplant Laboratory,University of Washington,Seattle,WA"},{"name":"Division of Transplant Surgery,University of Washington,Seattle,WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Imlay","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease,University of Utah,Salt Lake City,UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit P.","family":"Limaye","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,Clinical and Bio\u2010Analytics Transplant Laboratory,University of Washington,Seattle,WA"},{"name":"Division of Allergy and Infectious Diseases,University of Washington,Seattle,WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,7,31]]},"reference":[{"key":"lt26045-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.1111\/j.1600-6143.2011.03618.x","article-title":"Association of cytomegalovirus infection and disease with death and graft loss after liver transplant in high\u2010risk recipients","volume":"11","year":"2011","journal-title":"Am J Transplant"},{"key":"lt26045-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1097\/01.tp.0000226071.12562.1a","article-title":"Impact of cytomegalovirus in organ transplant recipients in the era of antiviral prophylaxis","volume":"81","year":"2006","journal-title":"Transplantation"},{"key":"lt26045-bib-0003-20250824","article-title":"Cytomegalovirus in solid organ transplant recipients\u2014guidelines of the American Society of Transplantation Infectious Diseases Community of 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