CMV specific T cell immunity predicts early viremia after liver transplantation

Transpl Immunol. 2018 Dec:51:62-65. doi: 10.1016/j.trim.2018.09.004. Epub 2018 Sep 20.

Abstract

Background: Cytomegalovirus (CMV) infection is one of the most important factors affecting liver transplant with direct and indirect effects. However, CMV disease after transplant remains poorly predicted.

Objective: In this study, preoperative CMV-specific cell-mediated immunity was evaluated in recipients of liver transplant in Korea, where most people are seropositive.

Methods: A total of 32 patients were enrolled in a prospective study, and blood samples were collected before liver transplant to determine CMV-specific cell-mediated immunity. Testing using ELiSpot IFN-γ (CMVspot) and CMV serology were performed simultaneously.

Results: CMVspot results showed that 30 recipients had CMV-specific cell-mediated immunity, of which 29 were positive for phosphoprotein 65 and 14 for immediate early protein 1 (IE-1). All patients were positive for CMV IgG before transplantation, and 17 patients had a CMV viremia episode after transplantation. CMVspot showed 100% specificity and positive predictive value, and 11.76% sensitivity to predict CMV viremia. Patients with positive or borderline results for IE-1 did not show viremia two months after transplantation (p = .041).

Conclusion: CMVspot may be helpful in establishing a treatment strategy that includes regular monitoring for risk stratification of CMV reactivation.

Keywords: CMV; Cell-mediated immunity; Interferon; Transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies, Viral / blood
  • Cells, Cultured
  • Cytomegalovirus / physiology*
  • Cytomegalovirus Infections / immunology*
  • Cytomegalovirus Infections / virology*
  • Enzyme-Linked Immunospot Assay
  • Female
  • Humans
  • Immediate-Early Proteins / immunology
  • Interferon-gamma / metabolism
  • Liver Transplantation*
  • Lymphocyte Activation
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Prognosis
  • Prospective Studies
  • Risk
  • T-Cell Antigen Receptor Specificity
  • T-Lymphocytes / immunology*
  • Viremia / diagnosis*
  • Viremia / etiology
  • Young Adult

Substances

  • Antibodies, Viral
  • IE1 protein, Human herpesvirus 1
  • Immediate-Early Proteins
  • Interferon-gamma