Features of the course and control of cytomegalovirus infection in children with orthotopic liver segment transplantation

Introduction. Liver transplantation is the only treatment option for liver fibrosis/cirrhosis. Cytomegalovirus (CMV) is the most common virus affecting liver transplant outcome and can lead to both graft loss and recipient death. Objective. To assess the incidence, causes, and course of CMV infection in children undergoing orthotopic liver transplantation in the early and late postoperative periods and the effectiveness of a combination of preventive and therapeutic measures for its control in a regional setting.
Materials and methods. An analysis of the incidence, causes, and course of CMV infection was conducted in 43 pediatric patients undergoing liver transplantation.
Results. Preoperative CMV carriage was detected in 14 patients. These patients had no viral replication in the blood and, therefore, no special therapeutic preparation with antiviral drugs was performed prior to surgery. Twenty-nine potential liver transplant recipients had CMV infection prior to surgery and received ganciclovir at a therapeutic dose until two negative blood PCR results were obtained (tests were performed 10 days apart) during preparation for surgery. Postoperatively, CMV infection was detected at various times in 39 children: asymptomatic viremia in 25, CMV syndrome in 5, and CMV disease in 9.
Conclusion. Following liver transplantation, CMV infection can develop in almost 100% of children, both early and late post-transplant. CMV infection can be controlled with flexible drug prophylaxis/therapy regimens combined with laboratory monitoring of infection activity (PCR), provided patients are maximally compliant with therapy, undergo dynamic monitoring, and are closely supervised by various medical specialists.
Contributions: Beloussova T.V., Nikulina A.B., Loskutova S.A. — concept and design of the study; Nikulina A.B. — collection and processing of data; Nikulina A.B., Loskutova S.A. — statistical processing of data; Nikulina A.B., Beloussova T.V., Loskutova S.A. — writing the text; Beloussova T.V., Nikulina A.B., Loskutova S.A., Porshennikov I.A. — editing the text. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgments. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.

Received: January 20, 2026
Accepted: February 10, 2026
Published: February 27, 2026

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