Background
Patients and methods
Patient population
CMV D+R- | CMV D+R+/D-R+ | |||||
---|---|---|---|---|---|---|
Initial CMV replication | all | yes | no | all | yes | no |
numbera | 25 | 9 | 16 | 48 | 6 | 42 |
Age, median years (range) | 60 (18–71) | 63 (25–71) | 59 (18–71) | 49 (21–73) | 53 (43–70) | 43 (21–73) |
Gender (m/f) | 15/10 | 6/3 | 9/7 | 33/15 | 5/1 | 28/14 |
Sample date, weeks postTx median (range) | 18 (2–383) | 30 (6–41) | 15 (2–383) | 27 (2–314) | 21 (5–138) | 17 (2–314) |
Induction (%) | 19 (76.0%) | 7 (77.8%) | 12 (54.5%) | 36 (75.0%) | 3 (50.0%) | 33 (76.7%) |
T-cell depleting induction (%) | 1 (4.0%) | 0 (0.0%) | 1 (4.5%) | 4 (8.3%) | 0 (0.0%) | 4 (9.3%) |
AR therapy (%) | 8 (32.0%) | 2 (22.2%) | 6 (27.3%) | 21 (43.8%) | 3 (50.0%) | 18 (41.9%) |
T-cell depleting AR therapy (%) | 3 (12.0%) | 0 (0.0%) | 3 (13.6%) | 11 (22.9%) | 2 (33.3%) | 9 (20.9%) |
Initial CMV load, mean (c/ml)a | - | 109'900 | < 300 | - | 49'588 | < 300 |
Initial CMV peak, mean (c/ml) | - | 181'811 | < 300 | - | 90'009 | < 300 |
Later CMV replication (n/total)b | - | 1/9 | 5/16 | - | 1/6 | 7/42 |
Later CMV load, mean (c/ml) | - | 288'001 | 9'323 | - | 1'489 | 72'581 |
Later CMV peak, mean (c/ml) | - | 1'240'000 | 37'260 | - | 3'387 | 311'071 |
CMV diagnostic assays
Quantification of CMV specific T cells
Data analysis
Results
Immunosuppression and CMV replication at the time of sampling
CMV-specific cellular immune response in kidney transplanted patients
Kidney transplant (KT) patients | Healthy donors (HD) | |||||||
---|---|---|---|---|---|---|---|---|
CMV D+R+/D-R+ n = 48, m = 79 | CMV D+R- n = 25, m = 50 | p-values* | CMV seropositive n = 13, m = 19 | CMV seronegative n = 17, m = 17 | p-values* | |||
CMV-
| CD3+ CD4+ | median (range) | 0.05 (0.00–4.35) | 0.01 (0.00–0.14) | < 0.001 | 1.03 (0.03–6.19) | 0.01 (0.00–0.22) | < 0.001 |
lysate
| CD3+ CD8+ | median (range) | 0.02 (0.00–1.31) | 0.00 (0.00–0.07) | 0.003 | 0.49 (0.00–4.57) | 0.00 (0.00–0.56) | < 0.001 |
pp72
| CD3+ CD4+ | median (range) | 0.04 (0.00–0.36) | 0.02 (0.00–0.26) | 0.027 | 0.08 (0.01–2.83) | 0.00 (0.00–0.03) | 0.001 |
peptides
| CD3+ CD8+ | median (range) | 0.05 (0.00–0.68) | 0.03 (0.00–0.34) | 0.056 | 0.2 (0.00–3.47) | 0.00 (0.00–0.03) | 0.002 |
pp65
| CD3+ CD4+ | median (range) | 0.02 (0.00–0.50) | 0.01 (0.00–0.55) | 0.013 | 0.11 (0.00–4.70) | 0.00 (0.00–0.02) | 0.018 |
peptides
| CD3+ CD8+ | median (range) | 0.02 (0.00–0.62) | 0.00 (0.00–0.25) | 0.001 | 0.21 (0.00–2.80) | 0.00 (0.00–0.20) | 0.009 |
CMV-specific cellular immune responses in seropositive KT patients with CMV replication
CMV replicating (n = 6/48) | CMV non-replicating (n = 42/48) | p-values* | |||
---|---|---|---|---|---|
CMV-
| CD3+CD4+ | median (range) | 0.02 (0.00–0.38) | 0.08 (0.00–4.35) | 0.011 |
lysate (m = 79)
| CD3+CD8+ | median (range) | 0.01 (0.00–0.21) | 0.02 (0.00–1.31) | 0.189 |
pp72
| CD3+CD4+ | median (range) | 0.04 (0.00–0.22) | 0.04 (0.00–0.36) | 0.291 |
peptides (m = 50)
| CD3+CD8+ | median (range) | 0.03 (0.00–0.24) | 0.07 (0.00–0.68) | 0.019 |
pp65
| CD3+CD4+ | median (range) | 0.00 (0.00–0.14) | 0.03 (0.00–0.50) | < 0.001 |
peptides
| CD3+CD8+ | median (range) | 0.01 (0.00–0.21) | 0.03 (0.00–0.62) | 0.033 |