Impact of OKT3 therapy on cytomegalovirus and herpes simplex virus infections after liver transplantation

The purpose of this study was to analyze the impact of OKT3 on the frequency and severity of CMV and herpes simplex virus (HSV) infections in adult liver transplant recipients. OKT3 treatment is associated with a higher risk of disseminated CMV infection, particularly in patients with primary CMV infection. It also increased the frequency of symptomatic HSV infection in HSV-seropositive liver transplant recipients

Fungal infections after liver transplantation

The risk factors for development of invasive fungal infections after liver transplantation were (1) longer duration of treatment with nonprophylactic IV antibiotics, (2) longer cumulative surgical time and a higher number of laparotomies, (3) an increased number of units of RBCs and fresh-frozen plasma, and (4) a series of pretransplant laboratory findings: thrombocytopenia, low T lymphocyte levels, low CD4 helper cell and lower helper/suppressor cell ratios and IgA serum levels. The significance of some of these findings is still unclear. Attention to the risk factors outlined earlier may aid both in preventing and in the early detection of invasive fungal infections after liver transplantation

Infections with cytomegalovirus and other herpesviruses in 121 liver transplant recipients: Transmission by donated organ and the effect of OKT3 antibodies

One hundred twenty-one adult liver transplant recipients were studied for the incidence, risk factors, and morbidity associated with herpesviruses infections after transplantation. The overall incidence of infection was 59% for cytomegalovirus (CMV), 35% for herpes simplex virus (HSV), 25% for Epstein-Barr virus (EBV), and 7% for varicella-zoster virus (VZV). Primary CMV infection occurred in 46% and reactivation CMV infection in 67% of the susceptible recipients. Symptomatic and disseminated CMV diseases were more common when patients developed primary infection (P .10). Although most HSV infections were oral or genital reactivations, three cases of HSV hepatitis occurred - one was primary infection. Symptomatic reactivations of HSV were observed in 53% of HSV-seropositive recipients who received OKT3, versus 31% of seropositive recipients who did not receive OKT3 (P = .05)