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Kinetic of the CMV ‐specific T‐cell immune response and CMV infection in CMV ‐seropositive kidney transplant recipients receiving rabbit anti‐thymocyte globulin induction therapy: A pilot study
Author(s) -
MartínGandul Cecilia,
PérezRomero Pilar,
MenaRomo Damián,
MolinaOrtega Alejandro,
GonzálezRoncero Francisco M.,
Suñer Marta,
Bernal Gabriel,
Cordero Elisa
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12883
Subject(s) - medicine , immune system , immunology , transplantation , immunity , kidney transplantation , t cell , cellular immunity
Abstract Background Some studies have suggested that rATG treatment may be associated with an increased incidence of CMV infection and delayed CMV immune response. However, the evidences supporting this matter are scarce. This study aims to characterize the kinetic of the CMV ‐specific T‐cell immune response before and after rATG induction therapy and the relationship with the development of CMV infection in CMV ‐seropositive kidney transplant recipients. Methods An observational prospective study of CMV ‐seropositive kidney transplant patients that received rATG induction therapy was performed. A pretransplant sample was obtained before the surgery to determine the CMV ‐specific immunity. CMV viral load (by PCR ) and CMV ‐specific T‐cell immune response (by flow cytometry) were determined during the follow‐up at 0.5, 1, 2, 3, 6, and 12 months post transplantation. Results A total of 23 patients were included in the study. CMV prophylaxis was administrated for a media of 90 days after transplantation. At the end of follow‐up, 18 (78.3%) patients had CMV ‐specific immunity with a median value of 0.31% CD 8 + CD 69 + INF ‐γ + T cells at a median of 16 weeks post transplantation. Five patients never acquired CMV ‐specific immunity. No statistically significant association between CMV infection and CMV ‐specific T‐cell immune response ( P = .086) was observed. However, patients with positive pretransplant CMV ‐specific immunity developed earlier immunity and achieved higher levels of CD 8 + CD 69 + INF ‐γ+ T‐cell post‐transplantation than patients with negative pretransplant immunity. Conclusions CMV ‐specific immune monitoring in addition to CMV ‐serology may be useful to stratify patient′s risk of CMV infection before transplantation.