title: Pre-transplant thymic function is associated with the risk of cytomegalovirus disease after solid organ transplantation.
abstract: Cytomegalovirus (CMV) disease is an important complication in solid organ transplant recipients. Thymic function in adults is associated with specific T-cell immunity. Pre-transplant thymic function was analysed in 75 solid organ transplant patients by the use of nested PCR. The primary outcome was the incidence of CMV disease 12 months after transplantation. Using multivariable logistic regression, we studied whether pre-transplant thymic function is an independent risk factor for CMV disease after transplantation. Thymic function was related to the risk of CMV disease in CMV-seropositive recipients. In these recipients, pre-transplant thymic function of <9.5 (OR 11.27, 95% CI 1.11-114.43, p 0.040) and the use of thymoglobulin (OR 8.21, 95% CI 1.09-61.84, p 0.041) were independent risk factors for CMV disease at 12 months after transplantation. Patients with pre-transplant thymic function values of <9.5 had a higher subsequent incidence of CMV disease (24%) than patients with values of ≥ 9.5 (3%) (log-rank test: 5.727; p 0.017). The positive and negative predictive values of these pre-transplant thymic function cut-offs were 0.24 (95% CI 0.10-0.45) and 0.97 (95% CI 0.82-1.00), respectively. Pre-transplant thymic function in CMV-seropositive candidates could be useful in determining the risk of post-transplant CMV disease in solid organ transplant patients, selecting a group of low-risk candidates.
authors: Maimónides Institute for Research in Biomedicine of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Spanish Network for Infectious Disease Research (REIPI RD12/0015), Instituto de Salud Carlos III, Seville, Spain.
authors: I
authors: I
authors: Gracia-Ahufinger
authors: Immunovirology Laboratory, Infectious Diseases Clinical Unit, Microbiology and Preventive Medicine, Biomedicine Institute of Seville (IBIS), Virgen del Rocío University Hospital, University of Seville, Seville, Spain; Molecular Immunology Laboratory, Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain; Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Bilbao, Spain.
authors: S
authors: S
authors: Ferrando-Martínez
authors: Infectious Diseases Unit, Cruces University Hospital, Bilbao, Spain.
authors: M
authors: M
authors: Montejo
authors: Maimónides Institute for Research in Biomedicine of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Spanish Network for Infectious Disease Research (REIPI RD12/0015), Instituto de Salud Carlos III, Seville, Spain.
authors: M C
authors: MC
authors: Muñoz-Villanueva
authors: Maimónides Institute for Research in Biomedicine of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Spanish Network for Infectious Disease Research (REIPI RD12/0015), Instituto de Salud Carlos III, Seville, Spain.
authors: S
authors: S
authors: Cantisán
authors: Maimónides Institute for Research in Biomedicine of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Spanish Network for Infectious Disease Research (REIPI RD12/0015), Instituto de Salud Carlos III, Seville, Spain.
authors: A
authors: A
authors: Rivero
authors: Maimónides Institute for Research in Biomedicine of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Spanish Network for Infectious Disease Research (REIPI RD12/0015), Instituto de Salud Carlos III, Seville, Spain.
authors: R
authors: R
authors: Solana
authors: Immunovirology Laboratory, Infectious Diseases Clinical Unit, Microbiology and Preventive Medicine, Biomedicine Institute of Seville (IBIS), Virgen del Rocío University Hospital, University of Seville, Seville, Spain. Electronic address: mleal@telefonica.net.
authors: M
authors: M
authors: Leal
authors: Maimónides Institute for Research in Biomedicine of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Spanish Network for Infectious Disease Research (REIPI RD12/0015), Instituto de Salud Carlos III, Seville, Spain.
authors: J
authors: J
authors: Torre-Cisneros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003586:Cytomegalovirus Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D012307:Risk Factors; D013950:Thymus Gland / Q000502:physiology*; D055815:Young Adult
keywords: CMV-seronegative; CMV-seropositive; cytomegalovirus replication; solid organ transplantation; thymic function