Acute cytomegalovirus infection in liver transplant recipients:An independent risk for venous thromboembolism

作     者：Raja GR Edula Kamran Qureshi Hicham Khallafi 

作者机构：Department of MedicineDivision of Gastroen-terology and HepatologyRutgers New Jersey School of Medi-cineNewark Department of HepatologyFlorida Hospital Transplant Center 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2013年第5卷第12期

页      面：692-695页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Cytomegalovirus Venous thromboembo-lism Orthotopic liver transplantation Thrombocytope-nia Hypersplenism 

摘      要：Acute cytomegalovirus(CMV) infection is a commonly encountered complication in the post liver transplant setting. We present a case of a 71-year-old male with acute CMV infection, initially presenting with a gastro- intestinal bleed due to acute CMV gastritis and later on complicated by acute venous thromboembolism occur- ring as an unprovoked event in the post liver transplant period. Traditional risk factors for venous thromboem- bolism have been well described in the medical litera- ture. Sporadic cases of thromboembolism due to CMV infection in the immune compromised patients have been described, especially in the post kidney transplant patients. Liver transplant recipients are equally prone to CMV infection particularly in the first year after suc- cessful transplantation. Venous thromboembolism in this special population is particularly challenging due to the fact that these patients may have persistent throm- bocytopenia and anticoagulation may be a challenge for the treating physician. Since liver transplantation is severely and universally limited by the availability of donor organs, we feel that this case report will provide valuable knowledge in the day to day management of these patients, whose clinical needs are complex and require a multidisciplinary approach in their care and management. Evidence and pathophysiology link- ing both the conditions is presented along with a brief discussion on the management, common scenarios en- countered and potential impact in this special group of patients.