Pre-transplant myeloid dendritic cell deficiency associated with cytomegalovirus infection and death after kidney transplantation.
BACKGROUND
Dendritic cells (DCs) are potent antigen-presenting cells critical for immunity. We previously demonstrated a significant association between pre-transplant blood myeloid dendritic cell (mDC) and plasmacytoid dendritic cell (pDC) deficiency and post-transplant BK viremia in renal transplant recipients. In the current post-hoc analysis, we studied the association of these same pre-transplant DC levels with other post-transplant outcomes.


METHODS
Pre-transplant peripheral blood mDC and pDC levels were quantified using flow cytometry in 78 patients undergoing kidney transplantation. Post-transplant outcomes were analyzed, including infection, rejection, and patient death, with a median follow-up of 5.3 years. Associations between DC levels and outcomes were assessed using logistic regression analysis and Cox proportional hazards models.


RESULTS
An independent association of mDC levels with post-transplant cytomegalovirus infection (adjusted odds ratio 7.0, P = 0.01) and patient death (adjusted hazard ratio 13.0, P = 0.015) was found. No associations were demonstrated between levels of either DC subtype and bacterial infections or rejection.


CONCLUSIONS
Pre-transplant mDC deficiency is significantly associated with CMV infection and death after kidney transplantation.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Q
Q
Sun
E C
EC
Hall
Y
Y
Huang
P
P
Chen
K
K
Dibadj
M
M
Murawski
R
R
Shraybman
K
K
Van Kirk
V
V
Tang
R
R
Peng
P R
PR
Patton
M J
MJ
Clare-Salzler
B
B
Kaplan
D L
DL
Segev
K L
KL
Womer
D000328:Adult; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000401:mortality*; D003713:Dendritic Cells / Q000502:physiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors