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Regular monitoring of cytomegalovirus-specific cell-mediated immunity in intermediate-risk kidney transplant recipients: predictive value of the immediate post-transplant assessment
- Source :
- Clinical Microbiology and Infection. 25:381.e1-381.e10
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Objective Previous studies on monitoring of post-transplant cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) are limited by single-centre designs and disparate risk categories. We aimed to assess the clinical value of a regular monitoring strategy in a large multicentre cohort of intermediate-risk kidney transplant (KT) recipients. Methods We recruited 124 CMV-seropositive KT recipients with no T-cell-depleting induction pre-emptively managed at four Spanish institutions. CMV-specific interferon-γ-producing CD4+ and CD8+ T cells were counted through the first post-transplant year by intracellular cytokine staining after stimulation with pp65 and immediate early-1 peptides (mean of six measurements per patient). The primary outcome was the occurrence of any CMV event (asymptomatic infection and/or disease). Optimal cut-off values for CMV-specific T cells were calculated at baseline and day 15. Results Twelve-month cumulative incidence of CMV infection and/or disease was 47.6%. Patients with pre-transplant CMV-specific CD8+ T-cell count Conclusions Monitoring for CMV-specific CMI in intermediate-risk KT recipients must be regular to reflect dynamic changes in overall immunosuppression and individual susceptibility. The early assessment at post-transplant day 15 remains particularly informative.
- Subjects :
- Male
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
T-Lymphocytes
medicine.medical_treatment
030106 microbiology
Congenital cytomegalovirus infection
Cytomegalovirus
Asymptomatic
Interferon-gamma
03 medical and health sciences
0302 clinical medicine
Monitoring, Immunologic
Predictive Value of Tests
Risk Factors
Immune monitoring intracellular cytokine staining
Internal medicine
medicine
Humans
Cumulative incidence
Lymphocyte Count
030212 general & internal medicine
Kidney transplantation
Aged
Immunity, Cellular
business.industry
Incidence (epidemiology)
virus diseases
Immunosuppression
General Medicine
Middle Aged
medicine.disease
Kidney Transplantation
Transplant Recipients
Transplantation
Infectious Diseases
Cytomegalovirus Infections
Cohort
Cell-mediated immunity
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 1198743X
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Clinical Microbiology and Infection
- Accession number :
- edsair.doi.dedup.....42ffd8eea6bb7618484171c7251c1cb5