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8% with ganciclovir: event rate difference of 0.041; 95% CI: ?0.038, 0.119). Furthermore, significantly fewer ganciclovir patients had EC-confirmed CMV disease or CMV infection by pp65 antigenemia or CMV DNA PCR compared to maribavir patients http://www.selleckchem.com/products/jq1.html at both 100 days (20% vs. 60%; p http://www.selleckchem.com/products/Rapamycin.html decreased allograft survival, and in some cases, higher overall post-transplant mortality (1,2). Common manifestations of CMV disease include CMV syndrome (fever, fatigue, leukopenia), gastrointestinal infection with abdominal pain and diarrhea, hepatitis, and pneumonia. Depending upon the CMV serostatus of the liver transplant recipient and donor prior to transplantation, the incidence of CMV disease after transplantation varies. Despite the use of either oral ganciclovir or valganciclovir prophylaxis after transplantation, CMV-seronegative patients receiving http://www.selleck.cn/products/AP24534.html a liver allograft from a CMV-seropositive donor continue to have the highest incidence of CMV disease (3,4). In a randomized controlled trial, oral ganciclovir was found to provide effective prophylaxis against CMV disease in liver transplant recipients (5). Recent meta-analyses have also shown that antiviral prophylaxis reduces the indirect effects of CMV infection and is generally more effective than pre-emptive therapy for prevention of CMV disease in high-risk CMV seronegative patients with CMV seropositive donors (6�C8). Similarly, oral valganciclovir, which has much higher oral bioavailability than ganciclovir (9), is approved for CMV prophylaxis in kidney and heart transplant recipients, although it failed to gain Food and Drug Administration (FDA) approval for use in liver transplant patients (10). Nevertheless, despite their effectiveness, the use of both ganciclovir and valganciclovir has been limited by frequent myelotoxicity (5,10) as well as the emergence of ganciclovir-resistant CMV strains (11,12). Thus, there is a growing need for newer antiviral agents, which are active against both wild-type and ganciclovir-resistant CMV strains and do not cause myelosuppression. Maribavir is an orally bioavailable benzimidazole riboside with a novel mechanism of action against CMV. Maribavir inhibits both CMV DNA assembly and egress of viral capsids from the nucleus of infected cells (13,14).