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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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| Published in: | Transplantation proceedings 2011-05, Vol.43 (4), p.1159-1161 |
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| creator | Costa, C Astegiano, S Terlizzi, M.E Sidoti, F Curtoni, A Solidoro, P Baldi, S Bergallo, M Cavallo, R |
| description | 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, |
| doi_str_mv | 10.1016/j.transproceed.2011.03.024 |
| format | article |
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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, <2,000 copies/mL), developed CMV pneumonia (confirmed by histopathology and immunohistochemistry) and died within 28 days. The prevalence of CMV DNA positivity on BAL did not differ in relation to the immune response; the mean viral load on BAL showed significantly higher results among nonresponders than responders, namely, 1.4 × 105 ± 2.4 × 105 copies/ml versus 7.9 × 103 ± 1.4 × 104 ( P = .02). Evaluation of CMV-specific cellular immune responses by in vitro immunologic monitoring complements virologic monitoring, helping to identify lung transplant recipients at risk of developing organ infection/disease.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2011.03.024</identifier><identifier>PMID: 21620077</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>Amsterdam: Elsevier Inc</publisher><subject>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</subject><ispartof>Transplantation proceedings, 2011-05, Vol.43 (4), p.1159-1161</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-6544928d5cdad79b124b34d460fab480104407e551821cf03b73c7cc4d93de7b3</citedby><cites>FETCH-LOGICAL-c379t-6544928d5cdad79b124b34d460fab480104407e551821cf03b73c7cc4d93de7b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>310,311,315,786,790,795,796,23958,23959,25170,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24220169$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21620077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Costa, C</creatorcontrib><creatorcontrib>Astegiano, S</creatorcontrib><creatorcontrib>Terlizzi, M.E</creatorcontrib><creatorcontrib>Sidoti, F</creatorcontrib><creatorcontrib>Curtoni, A</creatorcontrib><creatorcontrib>Solidoro, P</creatorcontrib><creatorcontrib>Baldi, S</creatorcontrib><creatorcontrib>Bergallo, M</creatorcontrib><creatorcontrib>Cavallo, R</creatorcontrib><title>Evaluation and Significance of Cytomegalovirus-Specific Cellular Immune Response in Lung Transplant Recipients</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>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, <2,000 copies/mL), developed CMV pneumonia (confirmed by histopathology and immunohistochemistry) and died within 28 days. The prevalence of CMV DNA positivity on BAL did not differ in relation to the immune response; the mean viral load on BAL showed significantly higher results among nonresponders than responders, namely, 1.4 × 105 ± 2.4 × 105 copies/ml versus 7.9 × 103 ± 1.4 × 104 ( P = .02). Evaluation of CMV-specific cellular immune responses by in vitro immunologic monitoring complements virologic monitoring, helping to identify lung transplant recipients at risk of developing organ infection/disease.</description><subject>Adult</subject><subject>Aged</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bronchoalveolar Lavage Fluid - virology</subject><subject>Chi-Square Distribution</subject><subject>Cytomegalovirus - genetics</subject><subject>Cytomegalovirus - immunology</subject><subject>Cytomegalovirus Infections - diagnosis</subject><subject>Cytomegalovirus Infections - immunology</subject><subject>Cytomegalovirus Infections - prevention & control</subject><subject>Cytomegalovirus Infections - virology</subject><subject>DNA, Viral - blood</subject><subject>DNA, Viral - isolation & purification</subject><subject>Enzyme-Linked Immunospot Assay</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Humans</subject><subject>Immunity, Cellular - drug effects</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Infectious diseases</subject><subject>Italy</subject><subject>Lung Transplantation - immunology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Monitoring, Immunologic - methods</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Time Factors</subject><subject>Tissue, organ and graft immunology</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viral Load</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqNkl2LEzEUhoMobnf1L0gQxKsZ8zVfXghSd3WhINj1OmSSMyU1k9RkptB_b8Z2UbzyKgnnOW8OT4LQa0pKSmj9bl9OUfl0iEEDmJIRSkvCS8LEE7SibcMLVjP-FK0IEbSgXFRX6DqlPclnJvhzdMVozQhpmhXyt0flZjXZ4LHyBm_tztvBauU14DDg9WkKI-yUC0cb51RsD6CXOl6Dc7NTEd-P4-wBf4N0CD4Bth5vZr_DD79ndMpPuabtwYKf0gv0bFAuwcvLeoO-390-rL8Um6-f79cfN4XmTTcVdSVEx1pTaaNM0_WUiZ4LI2oyqF60hBIhSANVRVtG9UB433DdaC1Mxw00Pb9Bb8-5WdLPGdIkR5t0Hll5CHOSbd3lAFKTTL4_kzqGlCIM8hDtqOJJUiIX3XIv_9YtF92ScJl15-ZXl2vmfsy1x9ZHvxl4cwFU0soNOUjb9IcTLMfVXeY-nTnIUo4Wokw6C9NgbAQ9SRPs_83z4Z8Y7azPr-l-wAnSPszRZ-2SysQkkdvlgyz_g9K8q1rKfwEYLrr-</recordid><startdate>201105</startdate><enddate>201105</enddate><creator>Costa, C</creator><creator>Astegiano, S</creator><creator>Terlizzi, M.E</creator><creator>Sidoti, F</creator><creator>Curtoni, A</creator><creator>Solidoro, P</creator><creator>Baldi, S</creator><creator>Bergallo, M</creator><creator>Cavallo, R</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201105</creationdate><title>Evaluation and Significance of Cytomegalovirus-Specific Cellular Immune Response in Lung Transplant Recipients</title><author>Costa, C ; Astegiano, S ; Terlizzi, M.E ; Sidoti, F ; Curtoni, A ; Solidoro, P ; Baldi, S ; Bergallo, M ; Cavallo, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-6544928d5cdad79b124b34d460fab480104407e551821cf03b73c7cc4d93de7b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bronchoalveolar Lavage Fluid - virology</topic><topic>Chi-Square Distribution</topic><topic>Cytomegalovirus - genetics</topic><topic>Cytomegalovirus - immunology</topic><topic>Cytomegalovirus Infections - diagnosis</topic><topic>Cytomegalovirus Infections - immunology</topic><topic>Cytomegalovirus Infections - prevention & control</topic><topic>Cytomegalovirus Infections - virology</topic><topic>DNA, Viral - blood</topic><topic>DNA, Viral - isolation & purification</topic><topic>Enzyme-Linked Immunospot Assay</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Humans</topic><topic>Immunity, Cellular - drug effects</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Infectious diseases</topic><topic>Italy</topic><topic>Lung Transplantation - immunology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Monitoring, Immunologic - methods</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Time Factors</topic><topic>Tissue, organ and graft immunology</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Costa, C</creatorcontrib><creatorcontrib>Astegiano, S</creatorcontrib><creatorcontrib>Terlizzi, M.E</creatorcontrib><creatorcontrib>Sidoti, F</creatorcontrib><creatorcontrib>Curtoni, A</creatorcontrib><creatorcontrib>Solidoro, P</creatorcontrib><creatorcontrib>Baldi, S</creatorcontrib><creatorcontrib>Bergallo, M</creatorcontrib><creatorcontrib>Cavallo, R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Costa, C</au><au>Astegiano, S</au><au>Terlizzi, M.E</au><au>Sidoti, F</au><au>Curtoni, A</au><au>Solidoro, P</au><au>Baldi, S</au><au>Bergallo, M</au><au>Cavallo, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation and Significance of Cytomegalovirus-Specific Cellular Immune Response in Lung Transplant Recipients</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2011-05</date><risdate>2011</risdate><volume>43</volume><issue>4</issue><spage>1159</spage><epage>1161</epage><pages>1159-1161</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>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, <2,000 copies/mL), developed CMV pneumonia (confirmed by histopathology and immunohistochemistry) and died within 28 days. The prevalence of CMV DNA positivity on BAL did not differ in relation to the immune response; the mean viral load on BAL showed significantly higher results among nonresponders than responders, namely, 1.4 × 105 ± 2.4 × 105 copies/ml versus 7.9 × 103 ± 1.4 × 104 ( P = .02). Evaluation of CMV-specific cellular immune responses by in vitro immunologic monitoring complements virologic monitoring, helping to identify lung transplant recipients at risk of developing organ infection/disease.</abstract><cop>Amsterdam</cop><pub>Elsevier Inc</pub><pmid>21620077</pmid><doi>10.1016/j.transproceed.2011.03.024</doi><tpages>3</tpages></addata></record> |
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| 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 |
| title | Evaluation and Significance of Cytomegalovirus-Specific Cellular Immune Response in Lung Transplant Recipients |
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