Korean J Transplant.  2023 Nov;37(Suppl 1):S176. 10.4285/ATW2023.F-7648.

ABO incompatibility is a risk factor for cytomegalovirus infection with living donor liver transplantation

• Choi MC
• Kim DG
• Yim SH
• Min EK
• Joo DJ
• Kim MS
• Lee JG

• KMID: 2551796
• DOI: http://doi.org/10.4285/ATW2023.F-7648

Abstract

Cytomegalovirus infection is the most common viral infection among liver transplant recipients. ABO incompatibility is considered a risk factor for cytomegalovirus infection because of the need for desensitization and immunosuppression. Whether ABO-incompatible living donor liver transplantation is associated with an increased incidence of cytomegalovirus infection remains controversial. We analyzed 630 patients who underwent living donor liver transplantation between 2012 and 2021 at Severance Hospital. Patients who were younger than 18 years of age, who died or underwent repeat transplantation within a 30-day period, who underwent combined organ transplantation, and those with incomplete data were excluded. We compared the incidence of cytomegalovirus infection within 1 year after liver transplantation of the ABO-incompatible (n=153) and ABO-compatible (n=477) groups. The cumulative incidence of cytomegalovirus infection of the ABO-incompatible group was approximately twice as high as that of the ABO-compatible group. According to the multivariate Cox proportional hazard model, ABO incompatibility was an independent risk factor for cytomegalovirus infection (hazard ratio, 2.138; P<0.001). The overall survival rate of ABO-incompatible recipients with cytomegalovirus infection was significantly lower than that of recipients without cytomegalovirus infection. ABO incompatibility is associated with a higher incidence of cytomegalovirus infection and an independent risk factor for cytomegalovirus infection when a preemptive treatment strategy is implemented.