Impact of Donor CMV‐Seropostive Grafts on Prognosis of Liver Transplantation for Hepatocellular Carcinoma

Studies investigating the impact of donor cytomegalovirus (CMV) positivity on the prognosis of liver transplantation (LT) recipients with HCC are currently lacking. A total of 21 759 eligible LT recipients were identified in the UNOS database between January 2002 and June 2023. The patients were divided into the donor CMV-seronegative (n = 7575) and CMV-seropositive (n = 14 814) groups. Moreover, the subgroup analyses by recipient age and gender were conducted. All patients were also divided into 18-40 (n = 271), 40-60 (n = 9538), and ≥ 60 (n = 11 950) groups, male (n = 16 954) and female (n = 4805) groups, respectively. Patients in the donor CMV-seropositive group had shorter overall survival (OS) and disease-free survival (DFS) compared to those in the donor CMV-seronegative group (both p < 0.001). Donor CMV seropositivity was proved to be a risk factor for OS and DFS (both p = 0.001). Patients receiving CMV-seropositive liver grafts had shorter OS and DFS in the 40-60 and ≥ 60 groups (all p < 0.05). Patients receiving CMV-seropositive liver grafts had shorted OS and DFS only in the male group (both p < 0.001). The receipt of donor CMV-seropositive liver grafts is associated with shorter survival and a higher risk of HCC recurrence in LT recipients with HCC. These adverse effects are influenced by recipient age and gender.