title: Association of the outcome of renal transplantation with antibody response to cytomegalovirus strain-specific glycoprotein H epitopes.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is the most important pathogen affecting the outcome of renal transplantation. The combination of CMV-seronegative transplant recipients with CMV-seropositive transplant donors places recipients at the highest risk of CMV disease. In cases of congenital CMV infection, existing immunity only partially protected mothers from reinfection with a different genotypic strain. The effect of differences in infected CMV strains between CMV-seropositive transplant donors and CMV seropositive transplant recipients on the outcome of transplantation remains unclear.
  
  
  METHODS
  In this prospective multicenter study, the presence of antibodies against strain-specific glycoprotein H epitopes in 84 CMV-seropositive transplant donor/CMV-seropositive transplant recipient renal transplantation cases were determined, and their relationships to acute transplant rejection, CMV infection, degree of antigenemia, and CMV disease were evaluated.
  
  
  RESULTS
  Among the 84 donor/recipient pairs, 45 and 32 had matched and mismatched strain-specific glycoprotein H antibodies, respectively. Acute transplant rejection in the mismatched group was more frequent than it was in the matched group (63% vs. 22%; P=.005). CMV disease was also more frequently observed in the mismatched group (28% vs. 9%; P=.026). The mismatched group had a higher level of antigenemia (P=.019).
  
  
  CONCLUSIONS
  Our results illustrate more adverse events in the cases with a CMV-seropositive transplant donor and a CMV-seropositive transplant recipient in which the glycoprotein H antibodies are mismatched, suggesting that reinfection with a different CMV strain results in more complications.
authors.affiliation: Department of Microbiology, Fukushima Medical University, Fukushima, Japan. keikun@fmu.ac.jp
authors.forename: Kei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Tokumoto
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirakawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kushida
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Yanagida
authors.forename: Naoki
authors.initials: N
authors.lastname: Inoue
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamaguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Toma
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Suzutani
mesh_terms: D000914:Antibodies, Viral / Q000096:biosynthesis* / Q000276:immunology; D000917:Antibody Formation; D000918:Antibody Specificity; D003587:Cytomegalovirus / Q000737:chemistry*; D003586:Cytomegalovirus Infections / Q000150:complications*; D004797:Enzyme-Linked Immunosorbent Assay; D006084:Graft Rejection / Q000821:virology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D014181:Transplantation Immunology; D014759:Viral Envelope Proteins / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D014759:Viral Envelope Proteins; C071440:glycoprotein H, Cytomegalovirus