Quantiferon-CMV Test, CMV-Specific ELISPOT and CMV-Dextramer Assays in Assessing the Risk of CMV Infection in Seropositive Kidney Transplant Recipients.
1Department of Laboratory Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Biomedical Science, Graduate School, The Catholic University of Korea, Seoul, Korea
3Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Meeting: 2016 American Transplant Congress
Abstract number: C282
Keywords: Cytomeglovirus, Infection, Kidney transplantation, T cells
Session Information
Session Name: Poster Session C: Viruses and SOT
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Human cytomegalovirus (CMV) infection is one of the primary opportunistic pathogens and is a leading cause of morbidity and mortality in kidney transplant recipients. Assessing pretransplant CMV-specific cell-mediated immunity (CMI) may be able to predict transplant recipients at risk of infection and reactivation.
We included 79 CMV-seropositive patients who received CMV-seropositive donor kidney (D+/R+). Pretransplant CMV specific CMIs were measured with Quantiferon-CMV assay (QF-CMV), CMV specific T-cell responses against CMV pp65 and IE-1 antigens using IFN-γ ELISPOT and CMV-dextramer assay for enumerating CMV antigen-specific CD8+ T cells (HLA-A*02, HLA-A*24). We compared these tests to evaluate their agreement, correlation and the abilities to predict CMV reactivation.
Of 79 seropositive recipients, 22.2% were pretransplant QF-CMV nonreactive (IFN-γ<0.2 IU/mL). CMV-ELISPOT pp65 and IE-1 tests were negative (<100 and <20 spots/2×105 lymphocytes) in 16.4% and 29.5% of patients, respectively. Overall agreement between QF-CMV and CMV-ELISPOT results was 70.5–75.4%. In ELISPOT assay, pp65 and IE-1 results positively correlated with correlation coefficient (r) = 0.34 (P=0.022). Pretransplant ELISPOT results showed no difference between QF-CMV reactive and nonreactive (pp65; 523.5 +/- 451.5 in reactive vs. 301.6 +/-322.0 in nonreactive, P=0.129, IE-1; 184.8+/-274.2 in reactive vs. 78.8+/-109.3 in nonreactive, P=0.215). Prevalence of recipients with HLA-A2 alleles were 64.3% in QF-CMV reactive and 43.8% in QF-CMV nonreactive (P=0.140). CMV-specific CD8+ T cells were detected as 1.38+/-2.21 % (0.0-10.0). CMV-specific CD8+ T cell % was higher in QF-CMV reactive than nonreactive patients (1.84+/-2.56 VS 0.26+/-0.47, P=0.032). Of 79 patients, 12.7% developed CMV episodes (CMV DNA > 3250 IU/mL) in post-KT 3 months and pretransplant CMV-specific CD8+ T cells ( >1.2%) predicted CMV reactivation with sensitivity 57.1%, specificity 71.4% (AUC 0.7).
The study demonstrated that pretransplant CMI results were variable in seropositive recipients and the CMV-dextramer assay at pre-transplantation might be useful for predicting the post-transplantation CMV reactivation.
CITATION INFORMATION: Lee H, Park K, Ryu J, Yu J, Chung B, Yang C, Oh E.-J. Quantiferon-CMV Test, CMV-Specific ELISPOT and CMV-Dextramer Assays in Assessing the Risk of CMV Infection in Seropositive Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Lee H, Park K, Ryu J, Yu J, Chung B, Yang C, Oh E-J. Quantiferon-CMV Test, CMV-Specific ELISPOT and CMV-Dextramer Assays in Assessing the Risk of CMV Infection in Seropositive Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/quantiferon-cmv-test-cmv-specific-elispot-and-cmv-dextramer-assays-in-assessing-the-risk-of-cmv-infection-in-seropositive-kidney-transplant-recipients/. Accessed May 31, 2025.« Back to 2016 American Transplant Congress