Elif Seren Tanriverdi, Yusuf Yakupogullari, Yasar Bayindir, Sami Akbulut, Sibel Altunisik Toplu, Harika Gozde Gozukara Bag, Burak Isik, Baris Otlu, Sezai Yilmaz
{"title":"抗病毒预防肝移植受者移植后巨细胞病毒特异性细胞免疫的预测价值","authors":"Elif Seren Tanriverdi, Yusuf Yakupogullari, Yasar Bayindir, Sami Akbulut, Sibel Altunisik Toplu, Harika Gozde Gozukara Bag, Burak Isik, Baris Otlu, Sezai Yilmaz","doi":"10.1016/j.transproceed.2025.07.006","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Existing data suggest that cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) in solid organ recipients may predict post-transplant CMV infection, but the available information is still limited, and needs to be validated for larger patient populations under certain circumstances. This study aimed to determine whether CMV-CMI could predict post-transplant CMV infection in liver transplant recipients (LTRs) receiving antiviral prophylaxis (AVP).</p><p><strong>Methods: </strong>A total of 1769 LTRs at the Inonu University Liver Transplantation Institute were retrospectively analyzed. CMV-CMI in a total of 334 patients (> 91% were CMV donor [D] positive/recipient [R] positive) who received AVP were analyzed using the CMV-Interferon (CMV-QF; QuantiFERON-CMV, Qiagen, Germany) assay within the week before transplantation. Patients were divided into two groups: group 1 (positive; n = 171, 51.2%) and group 2 (negative; n = 163, 48.8%). Patient variables were analyzed statistically.</p><p><strong>Results: </strong>A total of 124 LTRs developed CMV infection. Patients' pre-transplant characteristics did not differ significantly by their CMV-CMI result. A significantly lower percentage of LTRs with CMV-CMI positive developed infection than those with negatives (7.6% vs 68.1%, P < .001). All CMV-CMI positive patients fully recovered with antiviral treatment but only 76.6% of LTRs with negative CMV-CMI (P = .032). Logistic regression analysis showed that a negative CMV-CMI was associated with a 26 times increased risk of CMV infection compared to those with positive CMV-CMI (odds ratio [OR] = 25.9, P < .001). Female recipients developed CMV infection earlier after cessation of AVP than male recipients (median = 128 vs 144 days, P = .038).</p><p><strong>Conclusions: </strong>The pre-transplant status of CMV-CMI may be a strong indicator of post-transplant CMV infection for LTRs receiving AVP. Therefore, further consideration should be made for the LTRs with negative CMV-CMI.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive Value of Pretransplant Cytomegalovirus-Specific Cellular Immunity for Posttransplant CMV Infection in Liver Transplant Recipients Under Antiviral Prophylaxis.\",\"authors\":\"Elif Seren Tanriverdi, Yusuf Yakupogullari, Yasar Bayindir, Sami Akbulut, Sibel Altunisik Toplu, Harika Gozde Gozukara Bag, Burak Isik, Baris Otlu, Sezai Yilmaz\",\"doi\":\"10.1016/j.transproceed.2025.07.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Existing data suggest that cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) in solid organ recipients may predict post-transplant CMV infection, but the available information is still limited, and needs to be validated for larger patient populations under certain circumstances. This study aimed to determine whether CMV-CMI could predict post-transplant CMV infection in liver transplant recipients (LTRs) receiving antiviral prophylaxis (AVP).</p><p><strong>Methods: </strong>A total of 1769 LTRs at the Inonu University Liver Transplantation Institute were retrospectively analyzed. CMV-CMI in a total of 334 patients (> 91% were CMV donor [D] positive/recipient [R] positive) who received AVP were analyzed using the CMV-Interferon (CMV-QF; QuantiFERON-CMV, Qiagen, Germany) assay within the week before transplantation. Patients were divided into two groups: group 1 (positive; n = 171, 51.2%) and group 2 (negative; n = 163, 48.8%). Patient variables were analyzed statistically.</p><p><strong>Results: </strong>A total of 124 LTRs developed CMV infection. Patients' pre-transplant characteristics did not differ significantly by their CMV-CMI result. A significantly lower percentage of LTRs with CMV-CMI positive developed infection than those with negatives (7.6% vs 68.1%, P < .001). All CMV-CMI positive patients fully recovered with antiviral treatment but only 76.6% of LTRs with negative CMV-CMI (P = .032). Logistic regression analysis showed that a negative CMV-CMI was associated with a 26 times increased risk of CMV infection compared to those with positive CMV-CMI (odds ratio [OR] = 25.9, P < .001). Female recipients developed CMV infection earlier after cessation of AVP than male recipients (median = 128 vs 144 days, P = .038).</p><p><strong>Conclusions: </strong>The pre-transplant status of CMV-CMI may be a strong indicator of post-transplant CMV infection for LTRs receiving AVP. Therefore, further consideration should be made for the LTRs with negative CMV-CMI.</p>\",\"PeriodicalId\":94258,\"journal\":{\"name\":\"Transplantation proceedings\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation proceedings\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.transproceed.2025.07.006\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.transproceed.2025.07.006","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景：现有数据表明，实体器官受者巨细胞病毒（CMV）特异性细胞介导免疫（CMV- cmi）可能预测移植后巨细胞病毒感染，但现有信息仍然有限，需要在某些情况下对更大的患者群体进行验证。本研究旨在确定CMV- cmi是否可以预测肝移植受者（LTRs）接受抗病毒预防（AVP）后的移植后CMV感染。方法：回顾性分析猪野大学肝移植研究所1769例LTRs。采用CMV-干扰素（CMV- qf; CMV- qf）对接受AVP治疗的334例患者CMV- cmi进行分析，其中CMV供体[D]阳性/受体[R]阳性的CMV- 91%；QuantiFERON-CMV, Qiagen, Germany)在移植前一周内检测。患者分为两组：1组(阳性；N = 171, 51.2%)和2组(阴性；N = 163, 48.8%)。对患者变量进行统计分析。结果：124例ltr发生巨细胞病毒感染。移植前患者的CMV-CMI结果无显著差异。CMV-CMI阳性的LTRs发生感染的比例明显低于阴性的LTRs （7.6% vs 68.1%, P < 0.001）。所有CMV-CMI阳性患者在抗病毒治疗后均完全康复，但CMV-CMI阴性的lts只有76.6% （P = 0.032）。Logistic回归分析显示，CMV- cmi阴性患者感染CMV的风险是CMV- cmi阳性患者的26倍（优势比[OR] = 25.9, P < 0.001）。AVP停止后，女性受体比男性受体更早发生巨细胞病毒感染（中位数= 128 vs 144天，P = 0.038）。结论：移植前CMV- cmi的状态可能是AVP术后ltr移植后CMV感染的一个重要指标。因此，对于CMV-CMI阴性的LTRs应进一步考虑。
Predictive Value of Pretransplant Cytomegalovirus-Specific Cellular Immunity for Posttransplant CMV Infection in Liver Transplant Recipients Under Antiviral Prophylaxis.
Background: Existing data suggest that cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) in solid organ recipients may predict post-transplant CMV infection, but the available information is still limited, and needs to be validated for larger patient populations under certain circumstances. This study aimed to determine whether CMV-CMI could predict post-transplant CMV infection in liver transplant recipients (LTRs) receiving antiviral prophylaxis (AVP).
Methods: A total of 1769 LTRs at the Inonu University Liver Transplantation Institute were retrospectively analyzed. CMV-CMI in a total of 334 patients (> 91% were CMV donor [D] positive/recipient [R] positive) who received AVP were analyzed using the CMV-Interferon (CMV-QF; QuantiFERON-CMV, Qiagen, Germany) assay within the week before transplantation. Patients were divided into two groups: group 1 (positive; n = 171, 51.2%) and group 2 (negative; n = 163, 48.8%). Patient variables were analyzed statistically.
Results: A total of 124 LTRs developed CMV infection. Patients' pre-transplant characteristics did not differ significantly by their CMV-CMI result. A significantly lower percentage of LTRs with CMV-CMI positive developed infection than those with negatives (7.6% vs 68.1%, P < .001). All CMV-CMI positive patients fully recovered with antiviral treatment but only 76.6% of LTRs with negative CMV-CMI (P = .032). Logistic regression analysis showed that a negative CMV-CMI was associated with a 26 times increased risk of CMV infection compared to those with positive CMV-CMI (odds ratio [OR] = 25.9, P < .001). Female recipients developed CMV infection earlier after cessation of AVP than male recipients (median = 128 vs 144 days, P = .038).
Conclusions: The pre-transplant status of CMV-CMI may be a strong indicator of post-transplant CMV infection for LTRs receiving AVP. Therefore, further consideration should be made for the LTRs with negative CMV-CMI.
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