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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2022; 14(2): 338-353
Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.338
Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.338
Cytomegalovirus infection in liver-transplanted children
Norrapat Onpoaree, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Anapat Sanpavat, Division of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Anapat Sanpavat, Palittiya Sintusek, Thai Paediatric Gastroenterology, Hepatology and Immunology Research Unit, Chulalongkorn University, Bangkok 10330, Thailand
Palittiya Sintusek, Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Onpoaree N and Sintusek P reviewed the literature and wrote the manuscript; Sunpavat A interpreted the histopathological data and provided the histopathology images; Sintusek P provided the endoscopic images; and all authors approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Palittiya Sintusek, MD, MSc, Associate Professor, Lecturer, Thai Paediatric Gastroenterology, Hepatology and Immunology Research Unit, Chulalongkorn University, 1873 Rama IV Road, Pathum Wan, Bangkok 10330, Thailand. palittiya.s@chula.ac.th
Received: February 28, 2021
Peer-review started: February 28, 2021
First decision: March 29, 2021
Revised: April 17, 2021
Accepted: January 15, 2022
Article in press: January 15, 2022
Published online: February 27, 2022
Peer-review started: February 28, 2021
First decision: March 29, 2021
Revised: April 17, 2021
Accepted: January 15, 2022
Article in press: January 15, 2022
Published online: February 27, 2022
Core Tip
Core Tip: Cytomegalovirus (CMV) infection after liver transplantation in children is a serious complication, with high morbidity resulting from direct and indirect effects. Despite risk stratification, pre-emptive therapy and antiviral prophylaxis, late CMV infection frequently occurs in transplant recipients. If CMV infection is suspected during outpatient visits, then prompt detection is key. If CMV infection is detected, then decreasing immunosuppressants should be prioritized before initiation of antiviral therapy. Oral valganciclovir and intravenous ganciclovir are the mainstays of treatment, with variable duration depending on CMV manifestations, viral load, histopathology, and clinical response.