title: Pretransplant interferon-γ secretion by CMV-specific CD8+ T cells informs the risk of CMV replication after transplantation.
abstract: In this prospective study we analyzed pretransplant interferon-γ secretion by cytomegalovirus (CMV)-specific CD8+ T cells to assess its possible utility in determining the risk of CMV replication after solid organ transplantation. A total of 113 lung and kidney transplant patients were enrolled in the study but only 55 were evaluable. All CMV-seronegative recipients were pretransplant "nonreactive" (IFNγ <0.2 IU/mL) (11/11), whereas 30/44 (68.2%) CMV-seropositive (R+) recipients were "reactive" (IFNγ ≥0.2 IU/mL) and 14/44 (31.8%) were "nonreactive". In the R(+) "nonreactive" group, 7/14 (50%) developed posttransplant CMV replication, whereas the virus replicated only in 4/30 (13.3%) of the R(+) "reactive" patients (p = 0.021). According to the best multivariate model, pretransplant "nonreactive" recipients receiving an organ from a CMV-seropositive donor had a 10-fold increased risk of CMV replication compared to pretransplant "reactive" recipients (adjusted OR 10.49, 95% CI 1.88-58.46). This model displayed good discrimination ability (AUC 0.80) and calibration (Hosmer-Lemeshow test, p = 0.92). Negative and positive predictive values were 83.7% and 75%, respectively. The accuracy of the model was 82%. Therefore, assessment of interferon-γ secretion by cytomegalovirus (CMV)-specific CD8+ T cells prior to transplantation is useful in informing the risk of posttransplant CMV replication in solid organ transplant patients.
authors: Instituto Maimónides de Investigación Biomédica de Córdoba-Reina Sofia University Hospital-University of Cordoba, Cordoba, Spain. sacanti@hotmail.com
authors: S
authors: S
authors: Cantisán
authors: R
authors: R
authors: Lara
authors: M
authors: M
authors: Montejo
authors: J
authors: J
authors: Redel
authors: A
authors: A
authors: Rodríguez-Benot
authors: J
authors: J
authors: Gutiérrez-Aroca
authors: M
authors: M
authors: González-Padilla
authors: L
authors: L
authors: Bueno
authors: A
authors: A
authors: Rivero
authors: R
authors: R
authors: Solana
authors: J
authors: J
authors: Torre-Cisneros
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism*; D003587:Cytomegalovirus / Q000472:pathogenicity*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008137:Longitudinal Studies; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D007371:Interferon-gamma