Viral specific T cell therapy in kidney transplant recipients - A single-center experience

Transpl Infect Dis. 2023 Dec;25(6):e14179. doi: 10.1111/tid.14179. Epub 2023 Nov 1.

Abstract

Background: Viral infections such as adenovirus (ADV), BK virus (BKV), and cytomegalovirus (CMV) after kidney transplantation negatively impact outcomes in transplant recipients despite advancements in screening and antiviral therapy. We describe our experience of using the virus-specific T cell therapy (VSTs) in kidney transplant recipients (KTR) at our transplant center.

Methods: This is a retrospective, single center review of KTR with ADV, BKV and CMV infections between June 2021 and December 2022. These patients received third party VSTs as part of the management of infections. The immunosuppression, details of infection and outcome data were obtained from electronic medical records.

Results: Two cases of ADV infection resolved after one infusion of VSTs. The response rate of BKV and CMV infection was not as robust with close to 50% reduction in median viral load after VSTs. Out of 23 patients, two patients developed chronic allograft nephropathy from membranoproliferative glomerulonephritis and acute rejection.

Conclusion: Patients that are resistant to antivirals or who have worsening viremia despite conventional management may benefit from VSTs therapy to treat underlying viral infection. Additional studies are needed to ascertain efficacy and short- and long-term risks secondary to VSTs.

MeSH terms

  • BK Virus* / physiology
  • Cell- and Tissue-Based Therapy
  • Cytomegalovirus Infections* / complications
  • Cytomegalovirus Infections* / drug therapy
  • Humans
  • Kidney Transplantation* / adverse effects
  • Polyomavirus Infections* / complications
  • Retrospective Studies
  • Transplant Recipients
  • Tumor Virus Infections*