Evaluation and Significance of Cytomegalovirus-Specific Cellular Immune Response in Lung Transplant Recipients

Abstract In lung transplant recipients, cytomegalovirus (CMV) has been associated with direct ie, organ and systemic infection/disease, and indirect effects, including predisposition to develop acute rejection episodes and chronic allograft dysfunction. Cellular immune responses have been demonstrat...

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Bibliographic Details
Published in:Transplantation proceedings 2011-05, Vol.43 (4), p.1159-1161
Main Authors: Costa, C, Astegiano, S, Terlizzi, M.E, Sidoti, F, Curtoni, A, Solidoro, P, Baldi, S, Bergallo, M, Cavallo, R
Format: Article
Language:English
Subjects:
Adult
Aged
Antiviral Agents - therapeutic use
Biological and medical sciences
Bronchoalveolar Lavage Fluid - virology
Chi-Square Distribution
Cytomegalovirus - genetics
Cytomegalovirus - immunology
Cytomegalovirus Infections - diagnosis
Cytomegalovirus Infections - immunology
Cytomegalovirus Infections - prevention & control
Cytomegalovirus Infections - virology
DNA, Viral - blood
DNA, Viral - isolation & purification
Enzyme-Linked Immunospot Assay
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Humans
Immunity, Cellular - drug effects
Immunosuppressive Agents - therapeutic use
Infectious diseases
Italy
Lung Transplantation - immunology
Male
Medical sciences
Middle Aged
Monitoring, Immunologic - methods
Risk Assessment
Risk Factors
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Tissue, organ and graft immunology
Treatment Outcome
Viral diseases
Viral Load
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Summary:Abstract In lung transplant recipients, cytomegalovirus (CMV) has been associated with direct ie, organ and systemic infection/disease, and indirect effects, including predisposition to develop acute rejection episodes and chronic allograft dysfunction. Cellular immune responses have been demonstrated to play a role in the control of CMV replication. We evaluated CMV-specific cellular responses among lung transplant recipients associated with the onset of organ infection/disease. Cellular responses were evaluated by an Elispot assay of 48 specimens from 24 patients. All samples were evaluated beyond 1 year after transplantation; CMV DNA was concomitantly detected in bronchoalveolar lavage (BAL) and whole blood specimens. Each patient received a combined prolonged antiviral prophylaxis with CMV Ig for 12 months and gancyclovir or valgancyclovir for 3 weeks after postoperative day 21. Nine patients (37.5%) showed transient or persistent CMV nonresponses including donor-recipient negative serologic matching in 2 cases. Positive CMV DNA results were observed in 18/48 BAL specimens (37.5%) from 12 patients (50%). A viral load of >104 copies/mL was observed in only 3 cases, 2 of whom were positive also on whole blood. Among these 3 patients, 2 were responders and BAL (as well as whole blood) specimens collected subsequently were negative for CMV DNA; 1 nonresponder patient exhibited a viral load of 426,492 copies/mL BAL (DNAemia,
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2011.03.024