Pretransplant CMV-Specific T-Cell Immunity But Not Dose of Antithymocyte Globulin Is Associated With Recovery of Specific Immunity After Kidney Transplantation

Abstract Background This is a prospective, multicenter, observational study in cytomegalovirus (CMV)-seropositive kidney transplant recipients with pretransplant CMV-specific cell-mediated immunity (CMV-CMI) receiving antithymocyte globulin (ATG). We aimed to investigate posttransplant CMV-CMI over...

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Bibliographic Details
Published in:The Journal of infectious diseases 2021-04, Vol.223 (7), p.1205-1213
Main Authors: Páez-Vega, Aurora, Cantisán, Sara, Agüera, Maria L, Suñer, Marta, Facundo, Carmen, Yuste, Jose R, Fernández-Ruiz, Mario, Montejo, Miguel, Redondo-Pachón, Dolores, López-Oliva, Maria O, Fernández-Rodríguez, Ana, Fariñas, Maria C, Hernández, Domingo, Len, Oscar, Muñoz, Patricia, Valle-Arroyo, Jorge, Rodelo-Haad, Cristian, Cordero, Elisa, Torre-Cisneros, Julián
Format: Article
Language:English
Subjects:
Antilymphocyte serum
Antilymphocyte Serum - therapeutic use
Antiviral Agents - therapeutic use
Cell-mediated immunity
Cytomegalovirus
Cytomegalovirus Infections - drug therapy
Globulins
Humans
Immunity, Cellular
Interferon-gamma - analysis
Kidney Transplantation
Kidney transplants
Lymphocytes T
Prospective Studies
Recovery (Medical)
T-Lymphocytes
Thymocytes
γ-Interferon
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Summary:Abstract Background This is a prospective, multicenter, observational study in cytomegalovirus (CMV)-seropositive kidney transplant recipients with pretransplant CMV-specific cell-mediated immunity (CMV-CMI) receiving antithymocyte globulin (ATG). We aimed to investigate posttransplant CMV-CMI over time and the impact of the dose-dependent ATG. Methods CMV-CMI was assessed at days +30, +45, +60, and +90 after transplantation with the QuantiFERON-CMV assay. A reactive result (interferon-γ [IFN-γ] ≥ 0.2 IU/mL) indicated a positive CMV-CMI. Results A total of 78 positive CMV-CMI patients were enrolled in the study, of which 59.5% had a positive CMV-CMI at day +30 and 82.7% at day +90. Multivariate logistic regression analysis showed that ATG dose was not associated with positive CMV-CMI at any point. However, pretransplant IFN-γ level (>12 IU/mL vs ≤12 IU/mL) was associated with positive CMV-CMI at day +30 (odds ratio, 12.9; 95% confidence interval, 3.1–53.3; P 
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jiaa503