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 August 14, 2020.
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