Pretransplant CD8 T-Cell Response to IE-1 Discriminates Seropositive Kidney Recipients at Risk of Developing CMV Infection Posttransplant

López-Oliva, María O.; Martínez, Virginia; Buitrago, Agueda; Jiménez, Carlos; Rivas, Begoña; Escuín, Fernando; Santana, Maria; Selgas, Rafael; Bellón, Teresa

doi:10.1097/01.tp.0000438025.96334.eb

Cited by 39 publications

(28 citation statements)

References 27 publications

(20 reference statements)

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“…Could there be a mechanism whereby EBV replication protects healthy adults from BKV replication and vice versa? CMV viremia was associated with a decreased incidence of BKV reactivation in kidney transplant recipients in a recent study and while the authors proposed it could be due to reduction in immunosuppression (22); this could have been due to an ongoing protective CD8+ lymphocyte response activated by the preceding CMV (23). Perhaps a similar mechanism could explain our findings.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Donor Viral Replication at Transplant on Recipient Infections Posttransplant

et al. 2015

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Background Organ donors are often implicated as the source of posttransplant recipient infection. We prospectively studied kidney and liver donor-recipient pairs to determine if donor viral replication of cytomegalovirus (CMV), Epstein-Barr virus (EBV), and BK polyomavirus (BKV) at transplant was a risk factor for posttransplant recipient infection and disease. Methods Donors and recipients were studied for antibodies against CMV and EBV and for quantitative viral replication of CMV, EBV and BKV in oral washes, urine, and whole blood pretransplant. Recipient testing continued every 3 months posttransplant. Demographic and clinical data on infections and graft and subject outcomes were obtained. Results The 98 donor-recipient pairs included 15 liver and 83 kidney transplants (18 of whom were children). No donor had detectable CMV replication; therefore its impact on recipient CMV replication could not be analyzed. Donor EBV replication occurred in 22%, mostly in the oral wash and had no impact on posttransplant recipient EBV replication (p 0.9) or EBV viremia (p 0.6) in kidney or liver recipients. Donor BKV replication occurred in 17%, mostly in the urine and although not associated with posttransplant recipient urinary BKV replication in recipients, it was associated with BKV viremia (p 0.02), and a significantly shorter time to BKV viremia (p 0.01) in kidney recipients. Conclusion Donor replication of CMV or EBV did not impact posttransplant recipient viral replication in kidney/liver transplants. Donor urinary BKV replication is associated with recipient BKV viremia in kidney transplants.

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Section: Discussionmentioning

confidence: 99%

The Impact of Donor Viral Replication at Transplant on Recipient Infections Posttransplant

et al. 2015

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“…Indeed the latest consensus guidelines on HCMV in SOT recommended these methods as an adjunct tool to predict risk of viremia and disease [21]. The HCMV-specific cellular assays have been evaluated in different clinical scenarios: some studies have focused on the T-cell immunity in the pre-transplantation period to potentially predict subsequent viral infection or disease [82][83][84][85][86] (Table 3), many more studies have assessed HCMV-specific cellular responses after transplantation [76,[87][88][89][90][91][92][93][94][95][96][97][98] (Table 4). Few studies have assessed HCMV-specific cell-mediated immunity in large cohorts of high-risk SOT recipients (i.e., donor HCMV-seropositive/recipient HCMV-seronegative) to predict disease development [90].…”

Section: Hcmvmentioning

confidence: 99%

Approaches for monitoring of non virus-specific and virus-specific T-cell response in solid organ transplantation and their clinical applications

Calarota

Aberle

Puchhammer‐Stöckl

et al. 2015

Journal of Clinical Virology

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“…Ritta et al and Bestard et al found that having low pretransplant CMV‐specific T‐cell responses was associated with a higher risk of post‐transplant CMV replication . López‐Oliva et al reported that low pretransplant CMV‐specific CD8 + T‐cell counts predicted the development of CMV infection with 100% specificity and 85.7% sensitivity, while Mena‐Romo et al found that patients were more prone to suffer from CMV disease in the absence of detectable pretransplant CMI . More recently, the quantification of pretransplant CMV‐specific T‐cells directed against immediate early (IE)‐1, and/or pp65 antigens has been proven to be useful for the identification of R + kidney transplant recipients at increased risk for CMV‐disease …”

Section: Introductionmentioning

confidence: 99%

“…López‐Oliva et al reported that low pretransplant CMV‐specific CD8 + T‐cell counts predicted the development of CMV infection with 100% specificity and 85.7% sensitivity, while Mena‐Romo et al found that patients were more prone to suffer from CMV disease in the absence of detectable pretransplant CMI . More recently, the quantification of pretransplant CMV‐specific T‐cells directed against immediate early (IE)‐1, and/or pp65 antigens has been proven to be useful for the identification of R + kidney transplant recipients at increased risk for CMV‐disease Allo‐HSCT setting: To our knowledge, no studies have specifically investigated whether the assessment of CMV‐specific CMI may help to correctly classify allo‐HSCT candidates (and their donors) with respect to CMV infection status.…”

Section: Introductionmentioning

confidence: 99%

Going beyond serology for stratifying the risk of CMV infection in transplant recipients

Navarro

Fernández‐Ruiz

Aguado

et al. 2018

Reviews in Medical Virology

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Summary Knowledge of donor and recipient (D/R) cytomegalovirus (CMV) serostatus is critical for risk stratification of CMV infection and disease in transplant recipients, particularly in the solid organ transplantation (SOT) setting. Despite its broad availability and the success of it use, the risk stratification based on the D/R serostatus is not free of limitations since there are a nondepreciable number of patients that are not accurately categorized by this approach. In fact, up to 20% of seropositive SOT recipients, classically considered at intermediate risk, develop episodes of CMV infection and disease after transplantation. Here, we provide an overview of additional donor and recipient factors that may have utility in identifying patients at risk for post‐transplant CMV infection. Specifically, we summarize our current understanding regarding the potential use of use CMV‐specific T‐cell‐mediated immunity, neutralizing antibodies and host genetics that may influence the risk of CMV infection and disease. We provide an overview of the benefits and limitations associated with using these immunological factors in risk stratification and propose specific variables that could be analyzed at the pretransplant evaluation to improve the identification of patients with increased individual susceptibility.

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Pretransplant CD8 T-Cell Response to IE-1 Discriminates Seropositive Kidney Recipients at Risk of Developing CMV Infection Posttransplant

Abstract: Assessment of IE-1-specific CD8 T-cell frequencies pretransplant may be a useful tool for identifying seropositive SOT patients at risk of developing CMV infection posttransplant.

Cited by 39 publications

References 27 publications

The Impact of Donor Viral Replication at Transplant on Recipient Infections Posttransplant

The Impact of Donor Viral Replication at Transplant on Recipient Infections Posttransplant

Approaches for monitoring of non virus-specific and virus-specific T-cell response in solid organ transplantation and their clinical applications

Going beyond serology for stratifying the risk of CMV infection in transplant recipients

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