Association of the outcome of renal transplantation with antibody response to cytomegalovirus strain-specific glycoprotein H epitopes.
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.
Ishibashi
Kei
K
Department of Microbiology, Fukushima Medical University, Fukushima, Japan. keikun@fmu.ac.jp
Tokumoto
Tadahiko
T
Tanabe
Kazunari
K
Shirakawa
Hiroki
H
Hashimoto
Koichi
K
Kushida
Nobuhiro
N
Yanagida
Tomohiko
T
Inoue
Naoki
N
Yamaguchi
Osamu
O
Toma
Hiroshi
H
Suzutani
Tatsuo
T
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*
D000914:Antibodies, Viral; D014759:Viral Envelope Proteins; C071440:glycoprotein H, Cytomegalovirus