Pretransplant CMV-Specific T-Cell Immunity But Not Dose of Antithymocyte Globulin Is Associated With Recovery of Specific Immunity After Kidney Transplantation

Background. This is a prospective, multicenter, observational study in cytomegalovirus (CMV)-seropositive kidney transplant recipients with pretransplant CMV-specific cell-mediated immunity (CMV-CMI) receiving antithymocyte globulin (ATG). We aimed to investigate posttransplant CMV-CMI over time and...

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Detalles Bibliográficos
Autores: Paez-Vega, A, Cantisan, S, Aguera, ML, Suner, M, Facundo, C, Yuste, JR, Fernandez-Ruiz, M, Montejo, M, Redondo-Pachon, D, Lopez-Oliva, MO, Fernandez-Rodriguez, A, Farinas, MC, Hernandez, D, Len, O, Munoz, P, Valle-Arroyo, J, Rodelo-Haad, C, Cordero, E, Torre-Cisneros, J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p4851
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4851
http://hdl.handle.net/10902/24486
Access Level:acceso abierto
Palabra clave:cytomegalovirus infection
kidney transplant
kinetics of CMV-specific cell-mediated immunity
QuantiFERON-CMV assay
antithymocyte globulin
Descripción
Sumario:Background. This is a prospective, multicenter, observational study in cytomegalovirus (CMV)-seropositive kidney transplant recipients with pretransplant CMV-specific cell-mediated immunity (CMV-CMI) receiving antithymocyte globulin (ATG). We aimed to investigate posttransplant CMV-CMI over time and the impact of the dose-dependent ATG. Methods. CMV-CMI was assessed at days +30, +45, +60, and +90 after transplantation with the QuantiFERON-CMV assay. A reactive result (interferon-gamma [IFN-gamma] >= 0.2 IU/mL) indicated a positive CMV-CMI. Results. A total of 78 positive CMV-CMI patients were enrolled in the study, of which 59.5% had a positive CMV-CMI at day +30 and 82.7% at day +90. Multivariate logistic regression analysis showed that ATG dose was not associated with positive CMV-CMI at any point. However, pretransplant IFN-gamma level (>12 IU/mL vs <= 12 IU/mL) was associated with positive CMV-CMI at day +30 (odds ratio, 12.9; 95% confidence interval, 3.1-53.3; P <.001). In addition, all the patients who did not recover CMV-CMI at day +90 had a pretransplant IFN-gamma level <= 12 IU/mL. Conclusions. More than half of CMV-seropositive kidney transplant recipients receiving ATG recover (or maintain) CMV-CMI by the first month after transplantation. The pretransplant IFN-gamma level, but not the ATG dose, shows a strong association with the kinetics of this recovery.

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