在高风险脏和胰腺移植接受者中进行CMV inSIGHT T细胞免疫测试的真实世界经验
Jillian L Descourouez1, Jeannina A Smith2, Christopher M Saddler2
1Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
The Annals of pharmacotherapy
|October 28, 2023
概括
细胞巨乳病毒 (CMV) T 细胞免疫小组 (TCIP) 测定结果预测CMV DNAemia在移植受体中准确率为66.7%. 临床背景和时间对于解释TCIP结果至关重要,以管理CMV感染风险.
科学领域:
- 移植免疫学 移植免疫学
- 病毒学 病毒学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 细胞巨乳病毒 (CMV) 特定的细胞介导免疫对于移植后的CMV控制至关重要.
- 目前用于测量CMV免疫力的测定方法缺乏明确的治疗指南,特别是在没有先前暴露的高风险接受者中.
研究的目的:
- 评估SIGHT T细胞免疫小组 (TCIP) 试验中阳性CMV的预测价值,以确定CMVDNAemia的自由.
- 描述TCIP测试后后续3个月的CMV结果.
主要方法:
- 包括CMV风险较高的成年脏和/或胰腺移植接受者.
- 在2019年8月至2022年7月期间进行了TCIP测定.
- 为了分析,患者被分为预防和治疗队列.
主要成果:
- 在预防和治疗组中,TCIP对预测免疫力的积极预测值为66.7%.
- 在TCIP后的CMV感染发生在预防队列的10.2%,在治疗队列的22.2%出现复发.
- 观察到四例TCIP预测失败,其中两名患者具有混的临床因素.
结论:
- TCIP测定数据需要临床背景评估,因为CMV免疫控制可以波动.
- 移植后TCIP测试的时间和患者特定因素对于准确的CMV风险评估至关重要.
- 一个CMV管理计划可以提高TCIP结果的应用和解释.
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