Pretransplant CMV-Specific T-Cell Immunity But Not Dose of Antithymocyte Globulin Is Associated With Recovery of Specific Immunity After Kidney Transplantation
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Páez Vega, Aurora; Cantisán, Sara; Agüera, Maria L.; Suñer, Marta; Facundo, Carmen; Yuste, Jose R.; Fernández Ruiz, Mario; Montejo, Miguel; Redondo Pachón, Dolores; López Oliva, María O.; Fernández Rodríguez, Ana; Fariñas Álvarez, María del Carmen; Hernández, Domingo; Len, Óscar; Muñoz, Patricia; Valle Arroyo, Jorge; Rodelo Haad, Cristian; Cordero, Elisa; Torre Cisneros, ElisaFecha
2020Derechos
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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J Infect Dis
. 2021 Apr 8;223(7):1205-1213
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Oxford University Press
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Palabras clave
Cytomegalovirus infection
Kidney transplant
Kinetics of CMV-specific cell-mediated immunity
QuantiFERONCMV assay
Antithymocyte globulin
Resumen/Abstract
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-? [IFN-?] ? 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-? 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-? 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-? level, but not the ATG dose, shows a strong association with the kinetics of this recovery.
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