Date: Monday, June 13, 2016
Session Time: 4:30pm-6:00pm
Presentation Time: 4:42pm-4:54pm
Location: Room 306
CMV-seronegative kidney transplant recipients (KTRs) from CMV-seropositive donors are at highly increased risk of primary CMV-infection with associated inferior outcomes after kidney transplantation. Presence of CMV-specific T-cells despite seronegativity, however, may result from absence of detectable circulating antibodies despite CMV-specific memory B-cells or cross-reactivity due to allogeneic presensitization.
Here, we studied all CMV-seronegative KTRs between 2008 and 2013 for the presence of CMV-specific T-cells pretransplantation. Among 87 CMV-seronegative KTRs, 49 KTRs (56%) received an allograft from a CMV-seropositive and 38 KTRs (44%) from a CMV-seronegative donor. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation. CMV-specific T-cells to CMV-pp65, -IE1, and alloreactive T-cells were measured using an interferon-γ Elispot assay.
Among 49 KTRs from CMV-seropositive donors, 11 KTRs (22%) showed detectable CMV-specific T-cells pretransplantation. Although no differences were observed for the incidence of CMV-replication, KTRs with CMV-specific T-cells presented with shorter duration of CMV-replication, lower initial and peak CMV-loads, less CMV disease, and less need for intravenous antiviral therapy (p<0.05). KTRs with CMV-replication despite CMV-specific T-cells showed a loss of CMV-specific T-cells from pre- to posttransplantation (p<0.05). KTRs with no CMV-specific T-cells pretransplantation showed inferior patient survival, allograft survival, and allograft function (p<0.05). KTRs with CMV-replication showed a higher incidence of alloreactive T-cells and acute cellular rejection episodes (p<0.05).
A relevant proportion of CMV-seronegative KTRs shows CMV-specific T-cells pretransplantation with less severe primary CMV-infection and superior allograft outcomes compared to KTRs without CMV-specific T-cells. Higher frequencies of alloreactive T-cells may contribute to the higher incidence of acute cellular rejection in KTRs with CMV-replication.
CITATION INFORMATION: Schachtner T, Stein M, Reinke P. The Presence of CMV-Specific T-Cells in CMV-Seronegative Kidney Transplant Recipients Predicts Outcome After Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Schachtner T, Stein M, Reinke P. The Presence of CMV-Specific T-Cells in CMV-Seronegative Kidney Transplant Recipients Predicts Outcome After Kidney Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-presence-of-cmv-specific-t-cells-in-cmv-seronegative-kidney-transplant-recipients-predicts-outcome-after-kidney-transplantation/. Accessed October 24, 2020.
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