Cytomegalovirus infection in liver-transplanted children

Table 1 Risk of cytomegalovirus disease after liver transplantation

Risk factors
CMV serostatus of recipient and donor	D+/R−
	D+/R+ and D−/R+
Viral burden (initial CMV viral load)	High CMV viral load
	Rate of viral load increasing
Immunosuppressive agents	Antibody to CD3-receptor: OKT3 or muromonab
	Basiliximab
	Corticosteroids
	Mycophenolate mofetil
	Calcineurin inhibitors: Tacrolimus, sirolimus, and cyclosporine
Recipient immunity	TLR2 gene mutation, mutation of mannose-binding lectin
	Upregulation of programmed death-1 receptors
Recipient underlying liver disease	Hepatoblastoma with pre-transplant chemotherapy
Other risk factors	Virus-to-virus interaction (HHV6, HCV, fungal infection), transfusion of non-leucocyte-depleted blood products, volume of blood loss, liver transplantation because of fulminant liver failure, older age, non-white race, female sex, CVVH after liver transplant, septic shock, renal insufficiency

CMV: Cytomegalovirus; CVVH: Continuous venovenous haemofiltration; D: Donor; HCV: Hepatitis C virus; HHV-6: Human herpes virus-6; R: Recipient; TLR2: Toll-like receptor 2.