Monitoring of CMV‐specific cell‐mediated immunity with a commercial ELISA‐based interferon‐γ release assay in kidney transplant recipients treated with antithymocyte globulin

2020 ◽  
Vol 20 (8) ◽  
pp. 2070-2080 ◽  
Author(s):  
Mario Fernández‐Ruiz ◽  
Isabel Rodríguez‐Goncer ◽  
Patricia Parra ◽  
Tamara Ruiz‐Merlo ◽  
Laura Corbella ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Antithymocyte Globulin ◽  
Interferon Γ ◽  
Cell Mediated Immunity ◽  
Specific Cell ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Release Assay

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

2020 ◽  
Author(s):  
Aurora Páez-Vega ◽  
Sara Cantisán ◽  
Maria L Agüera ◽  
Marta Suñer ◽  
Carmen Facundo ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Antithymocyte Globulin ◽  
Multivariate Logistic Regression Analysis ◽  
Cell Mediated Immunity ◽  
Specific Cell ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cell Immunity ◽  
Ifn Γ ◽  
The Impact

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 < .001). In addition, all the patients who did not recover CMV-CMI at day +90 had a pretransplant IFN-γ level ≤12 IU/mL. Conclusions More than half of CMV-seropositive kidney transplant recipients receiving ATG recover (or maintain) CMV-CMI by the first month after transplantation. The pretransplant IFN-γ level, but not the ATG dose, shows a strong association with the kinetics of this recovery.

scholarly journals SARS-CoV-2-Specific Cell-Mediated Immunity in Kidney Transplant Recipients Recovered from COVID-19.

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mario Fernández-Ruiz ◽  
Beatriz Olea ◽  
Estela Giménez ◽  
Rocío Laguna-Goya ◽  
Hernando Trujillo ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Cell Mediated Immunity ◽  
Specific Cell ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Different impact of rATG induction on CMV infection risk in D+R– and R+ KTRs

2019 ◽  
Vol 220 (5) ◽  
pp. 761-771 ◽  
Author(s):  
Hannah Kaminski ◽  
Marta Jarque ◽  
Mathieu Halfon ◽  
Benjamin Taton ◽  
Ludovic Di Ascia ◽  
...  
Keyword(s):  
Interleukin 2 ◽  
Interferon Γ ◽  
Preventive Therapy ◽  
Cell Mediated Immunity ◽  
Specific Cell ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cmv Infection ◽  
Cmv Dnaemia

Abstract Background Rabbit antithymocyte globulin (rATG) induction is associated with profound immunosuppression, leading to a higher risk of cytomegalovirus (CMV) infection compared with anti–interleukin 2 receptor antibody (anti–IL-2RA). However, this risk, depending on the baseline CMV serological recipient/donor status, is still controversial. Methods The CMV DNAemia-free survival between rATG- and anti–IL-2RA–treated patients was analyzed in donor-positive/recipient-negative (D+R−) and recipient-positive (R+) patients in 1 discovery cohort of 559 kidney transplant recipients (KTRs) and 2 independent cohorts (351 and 135 kidney KTRs). The CMV-specific cell-mediated immunity (CMI) at baseline and at different time points after transplantation was assessed using an interferon γ enzyme-linked immunosorbent spot assay. Results rATG increased the risk of CMV DNAemia in R+ but not in D+R− KTRs. In R+ CMI-positive (CMI+) patients, the CMV DNAemia rate was higher in rATG-treated than in anti–IL-2RA–treated patients; no difference was observed among R+ CMI-negative (CMI−) patients. Longitudinal follow-up demonstrated a deeper depletion of preformed CMV CMI in R+ rATG-treated patients. Conclusions D+R− KTRs have the highest risk of CMV DNAemia, but rATG adds no further risk. Among R+ KTRs, we described 3 groups, the least prone being R+CMI+ KTRs without rATG, then R+CMI+ KTRs with rATG, and finally R+CMI− KTRs. CMV serostatus, baseline CMV-specific CMI, and induction therapy may lead to personalized preventive therapy in further studies.

Sign in / Sign up

Export Citation Format

Share Document