A Primary Cytomegalovirus Infection Post-Transplantation Has a Significant Impact on Circulating T Cells and Renal Allograft Function

R. Meijers,¹ N. Litjes,¹ A. Langerak,² C. Baan,¹ M. Betjes.¹

¹Internal Medicine section Nephrology and Transplantation, Erasmus MC, Rotterdam, Netherlands
²Immunology, Erasmus MC, Rotterdam, Netherlands.

Meeting: 2015 American Transplant Congress

Abstract number: C242

Keywords: Cytomeglovirus, Kidney transplantation, Renal function, T cells

Session Information

Session Name: Poster Session C: Translational Biomarkers and Immune Monitoring

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Study's purpose: Cytomegalovirus (CMV)-infection may profoundly affect the peripheral T-cell compartment and is associated with T-cell ageing and generation of cytotoxic CD4+CD28null T cells. We investigated the effect of a primary CMV-infection post-Kidney transplantation (KTx) in CMV-seronegative recipients receiving a kidney from a CMV-seropositive donor (D+/R-) on peripheral T cells under immunosuppression and valganciclovir prophylaxis.

Methods: Within the first year post-KTx, the presence of CMV-specific T cells and T-cell differentiation status were monitored. In addition, as ageing parameters we measured the thymic output by the T-cell receptor excision circle (TREC)-content and CD31-expressing naive T-cell numbers and the proliferative history by the relative telomere length (RTL). The D+/R- KTx-recipients were compared to recipients of a D+/R+ combination.

Results: In 12 out of 23 D+/R- KTx recipients CMV viremia was detected within the first year post-KTx whereas 3 other patients showed a serological response to CMV without a viremic episode and detectable CMV-specific T cells. Only in the viremic patients a significant impact of CMV-infection on T cells was observed. They developed CMV-specific, (IFN-γ-producing) CD137-expressing CD4+ and CD8+ T cells and their T-cell compartment shifted towards more differentiated memory cells with expansion of CD4+CD28null and CD8+CD28null T cells. One year post-KTx the total CD8+ T-cell count was almost doubled in this group compared to non-viremic D+/R- and D+/R+ recipients. Both the TREC-content (p=0.004) and CD31+naive CD4+ (p=0.04) and CD8+ (p=0.05) T-cell numbers were significantly decreased at 12 months post-KTx. The RTL of CD8+, but not CD4+ T cells significantly (p=0.04) declined in the D+/R- KTx-recipients post-KTx. The viremic D+/R- patients had a significant (p<0.01) lower glomerular filtration rate compared to D+/R+ KTx recipients at 12 months post-KTx.

Conclusion: A primary CMV-infection significantly impacts the peripheral T cells and enhances immunological T-cell ageing. In addition, primary CMV-infection negatively affects renal allograft function.

(This study was financially supported by the Dutch Kidney Foundation (KSPB.10.12)).

To cite this abstract in AMA style:

Meijers R, Litjes N, Langerak A, Baan C, Betjes M. A Primary Cytomegalovirus Infection Post-Transplantation Has a Significant Impact on Circulating T Cells and Renal Allograft Function [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/a-primary-cytomegalovirus-infection-post-transplantation-has-a-significant-impact-on-circulating-t-cells-and-renal-allograft-function/. Accessed May 6, 2025.

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