Predictive Value of Pretransplant Cytomegalovirus-Specific Cellular Immunity for Posttransplant CMV Infection in...

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).

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.

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).

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.