Key Points

1. Cytomegalovirus (CMV) is a common infection after liver transplantation and manifests as an asymptomatic infection or clinically as CMV syndrome (fever and myelosuppression) or tissue-invasive CMV disease.

2. The most common risk factor for CMV disease is donor positivity and recipient negativity for CMV, and severe impairment in immunity, especially with a pathogen-specific immune response, generally predisposes patients to CMV disease after transplantation.

3. The prevention of CMV disease after liver transplantation consists of preemptive therapy (antiviral therapy is administered only in the presence of a positive CMV polymerase chain reaction or pp65 antigenemia) or antiviral prophylaxis (an antiviral drug is administered to all patients at risk of CMV disease).

4. The treatment of CMV disease consists of intravenous ganciclovir (for severe disease) or oral valganciclovir (for mild to moderate CMV disease). Liver Transpl 16:S45-S53, 2010. © 2010 AASLD.