Pretransplant CMV-Specific T-Cell Immunity But Not Dose of Antithymocyte Globulin Is Associated With Recovery of Specific Immunity After Kidney Transplantation
Por:
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
Publicada:
1 abr 2021
Resumen:
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.
Filiaciones:
Paez-Vega, A:
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Cantisan, S:
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Reina Sofia Univ Hosp, Infect Dis Serv, Cordoba, Spain
Aguera, ML:
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain
Reina Sofia Univ Hosp, Nephrol Serv, Cordoba, Spain
Suner, M:
Virgen del Rocio Univ Hosp, Nephrol Serv, Seville, Spain
Facundo, C:
Puigvert Fundacio, Nephrol Serv, Barcelona, Spain
Yuste, JR:
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Univ Clin Navarra, Infect Dis Unit, Pamplona, Spain
Fernandez-Ruiz, M:
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Res Inst Hosp 12 Octubre, Unit Infect Dis, Madrid, Spain
Montejo, M:
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Cruces Univ Hosp, Infect Dis Serv, Bilbao, Spain
Redondo-Pachon, D:
Hosp del Mar, Nephrol Serv, Barcelona, Spain
Lopez-Oliva, MO:
La Paz Univ Hosp, Nephrol Serv, Madrid, Spain
Fernandez-Rodriguez, A:
Ramon y Cajal Univ Hosp, Nephrol Serv, Madrid, Spain
Farinas, MC:
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Univ Cantabria, Marques de Valdecilla Hosp, Inst Invest Marques de Valdecilla, Infect Dis Serv, Santander, Spain
Hernandez, D:
Univ Malaga, Reg Univ Hosp Carlos Haya, Inst Biomed Res Malaga IBIMA, Nephrol Serv, Malaga, Spain
Len, O:
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Hosp Univ Vall dHebron, Infect Dis Serv, Barcelona, Spain
Munoz, P:
Gregorio Maranon Univ Hosp, Dept Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest Biomed Gregorio Maranon, Madrid, Spain
Univ Complutense Madrid, Madrid, Spain
CIBERES CB06 06 0058, Madrid, Spain
Univ Complutense Madrid, Dept Med, Madrid, Spain
Valle-Arroyo, J:
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Rodelo-Haad, C:
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain
Reina Sofia Univ Hosp, Nephrol Serv, Cordoba, Spain
Cordero, E:
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Virgen del Rocio Univ Hosp, Infect Dis Unit, Seville, Spain
Torre-Cisneros, J:
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis, Madrid, Spain
Reina Sofia Univ Hosp, Infect Dis Serv, Cordoba, Spain
Green Accepted
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