Utility of Cytomegalovirus T-Cell Immunity Panel to Predict CMV Infections in Lung Transplant Recipients
1Pharmacy, Houston Methodist Hospital, Houston, TX, 2Pulmonology, Houston Methodist Hospital, Houston, TX
Meeting: 2022 American Transplant Congress
Abstract number: 1467
Keywords: CD4, IgG, Leukocytes, Lung infection
Topic: Clinical Science » Lung » 64 - Lung: All Topics
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Given the limited data of cytomegalovirus T-cell immunity panels (CMV TCIP) in lung transplant recipients (LTR), we sought to describe our center’s experience with CMV TCIP in LTR.
*Methods: We reviewed all CMV TCIP results from LTRs drawn between 1/2019 – 6/2021. LTRs were excluded if they received a multi-organ transplant or re-transplantation. TCIP results were excluded if there was an assay control error or if no CMV PCR was checked after assay collection. Our primary outcome was the rate of CMV infection any point after TCIP collection. Secondary endpoints included CD4% and CD8%, characteristics of LTR’s who developed CMV infection, assessment of serial CMV TCIP monitoring, and characteristics of LTRs who did not show immunity.
*Results: A total of 191 CMV TCIPs from 156 LTRs were evaluated. Median time from transplant to CMV TCIP was 687 (389-1508) days. One hundred and twenty assays (62.8%) demonstrated immunity (both CD4% and CD8% >0.2%), with median CMV CD4% = 0.63% and CD8% = 1.42%. Twenty LTRs experienced a CMV infection after a TCIP was checked, 85% developed CMV after CMV TCIP was positive for immunity. CMV infection developed a median 121 of days after TCIP and 30% were off prophylaxis. Median CMV CD4% and CD8% in those who developed infection post-positive TCIP were 2.01% and 1.46%, respectively. Four LTRs developed a CMV infection after CMV prophylaxis was removed. Three LTR’s developed invasive CMV disease. Twenty-nine patients had two or more CMV TCIP drawn. Median time between repeat CMV TCIP was 168 (122-298) days. The median change in CD4% and CD8% was -0.01 and 0.01 respectively. Twenty-five of the 72 patients who did not express CMV immunity were CMV IgG negative at time of transplant.
*Conclusions: The preliminary results of this study suggest that a threshold for CD4% and CD8% specific for CMV immunity in LTR needs to be established and additional patient factors need to be considered in the decision to stop CMV prophylaxis. There were marginal changes in TCIP with repeat testing. Prospective trials are needed to assess the utility of serial TCIP monitoring.
To cite this abstract in AMA style:
Lincoln RW, Pierce BJ, Pham C, Yau SW, Goodarzi A, Youssef JG, Huang HJ. Utility of Cytomegalovirus T-Cell Immunity Panel to Predict CMV Infections in Lung Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/utility-of-cytomegalovirus-t-cell-immunity-panel-to-predict-cmv-infections-in-lung-transplant-recipients/. Accessed May 18, 2025.« Back to 2022 American Transplant Congress