CMV specific T cell immune response in hepatitis C negative kidney transplant recipients receiving transplant from hepatitis C viremic donors and hepatitis C aviremic donors
Ambreen Azhar,
Makoto Tsujita,
Manish Talwar,
Vasanthi Balaraman,
Anshul Bhalla,
James D. Eason,
Simonne S. Nouer,
Keiichi Sumida,
Adam Remport,
Isaac E. Hall,
Randi Griffin,
George Rofaiel,
Miklos Z. Molnar
Affiliations
Ambreen Azhar
Department of Medicine, Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
Makoto Tsujita
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Manish Talwar
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Vasanthi Balaraman
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Anshul Bhalla
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
James D. Eason
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Simonne S. Nouer
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Keiichi Sumida
Department of Medicine, Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
Adam Remport
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
Isaac E. Hall
Department of Medicine, Division of Nephrology & Hypertension, University of Utah, Salt Lake City, UT, USA
Randi Griffin
Office of Clinical Research, University of Tennessee Health Science Center, Memphis, TN, USA
George Rofaiel
Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, University of Utah, Salt Lake City, UT, USA
Miklos Z. Molnar
Department of Medicine, Division of Nephrology & Hypertension, University of Utah, Salt Lake City, UT, USA
Kidney transplants (KT) from hepatitis C (HCV) viremic donors to HCV negative recipients has shown promising renal outcomes, however, high incidence of cytomegalovirus (CMV) viremia were reported. We performed a prospective cohort study of 52 HCV negative KT recipients from Methodist University Hospital including 41 receiving transplants from HCV aviremic donors and 11 from HCV viremic donors. CMV specific CD4+ and CD8 + T cell immunity was measured by intracellular flow cytometry assay. Primary outcome was the development of positive CMV specific CD4+ and CD8 + T cell immune response in the entire cohort and each subgroup. The association between donor HCV status and CMV specific CD4+ and CD8 + T cell immune response was analyzed by Cox proportional hazard models. Mean recipient age was 48 ± 13 years, with 73% male and 82% African American. Positive CMV specific CD4+ and CD8 + T cell immune response was found in 53% and 47% of the cohort at 1 month, 65% and 70% at 2 months, 80% and 75% at 4 months, 89% and 87% at 6 months, and 94% and 94% at 9 months post-transplant, respectively. There was no significant difference in the incidence of positive CMV specific T cell immune response between recipients of transplants from HCV aviremic donors compared to HCV viremic donors in unadjusted (for CD8+: HR = 1.169, 95%CI: 0.521–2.623; for CD4+: HR = 1.208, 95%CI: 0.543–2.689) and adjusted (for CD8+: HR = 1.072, 95%CI: 0.458–2.507; for CD4+: HR = 1.210, 95%CI: 0.526–2.784) Cox regression analyses. HCV viremia in donors was not associated with impaired development of CMV specific T cell immunity in this cohort.
