Table 4.
Profiles of the 2 recipients with biopsy-proven CMV colitis after living donor liver transplantation.
| Category | Recipient No. 1 | Recipient No. 2 |
|---|---|---|
| Age (years) | 67 | 59 |
| Gender | Male | Female |
| Etiology of underlying liver disease | Non-B, non-C liver cirrhosis | Angiosarcoma, ruptured |
| Clinical symptoms | Abdominal pain, diarrhea | Abdominal pain |
| Lesion site | Transverse colon Descending colon |
Ascending colon Transverse colon Sigmoid colon |
| Colonoscopy findings | Segmental ulcer with intra-luminal narrowing | Patchy ulcers |
| Serum laboratory test | ||
| Recipient | ||
| Anti-CMV IgM | ||
| Pre-transplant, Index | Negative (0.08) | Negative (0.19) |
| Post-transplant (at time of disease), Index | Negative (0.06) | Negative (0.34) |
| Anti-CMV IgG | ||
| Pre-transplant, AU/mL | Positive (2115.3) | Positive (73.6) |
| Post-transplant (at time of disease), AU/mL | Positive (1199.3) | Positive (2280.9) |
| CMV-DNA PCR (at time of disease) IU/mL | Not detectable | Positive (123) |
| WBC (at time of disease) 1000/uL | 16.2 | 6.2 |
| CRP (at time of disease) mg/L | 89.72 | 9.7 |
| N/L ratio | 2.99 | 0.93 |
| Donor | ||
| Anti-CMV IgM (Index) | Negative (0.08) | Negative (0.06) |
| Anti-CMV IgG (AU/mL) | Positive (615.3) | Negative (1.8) |
| CMV-DNA PCR (IU/mL) | Not available | Not available |
| Pathology | ||
| Inclusion bodies | Present | Present |
| CMV IHC staining | Positive | Positive |
| Anti-viral medication | ||
| Ganciclovir | 14 days | 12 days |
| Valganciclovir | 90 days | 160 days |
| Anti-viral medication duration (days) | 104 days | 172 days |
| Time to disease | 10 years after LDLT | 2 months after LDLT |
| Immunosuppressants use at time of CMV colitis | Mycophenolate mofetil 250mg Q12H PO, Tacrolimus 1mg QD PO | Mycophenolate mofetil 500 mg Q12H PO Prednisolone 5mg TID PO Tacrolimus 2mg QD PO |
| Post-LDLT outcomes | ||
| Allograft dysfunction | No | No |
| Biliary tract stricture | No | Present |
| Acute cellular rejection | Yes | No |