@article{087dfb880e814d8ba0b7b01b9b006208,
title = "A prospective multicenter observational study of cell-mediated immunity as a predictor for cytomegalovirus infection in kidney transplant recipients",
abstract = "T cell immunity is essential for the control of cytomegalovirus (CMV) infection after transplantation. We evaluated a CMV-specific peptide-based enzyme-linked immunosorbent spot (ELISPOT) assay to determine whether assay results could predict subsequent CMV events. Adult kidney transplant recipients at 43 centers underwent ELISPOT testing to enumerate interferon gamma (IFN-γ) binding spot-forming units (sfu) after stimulation of cells with an overlapping peptide pool of CMV phosphoprotein 65 (pp65) and immediate early-1 (IE-1) protein at the end of antiviral prophylaxis (EOP) and various time points thereafter. The primary outcome was a CMV event in the first posttransplant year. In 583 kidney transplant recipients (260 seropositive donor [D+]/seronegative recipient [R−] and 277 R+), CMV events occurred in 44 of 368 eligible patients (11.8%) at a median of 227 days (range 92-360) posttransplant. A cutoff value of >40 sfu/2.5 × 105 cells for either IE-1 or pp65 was derived as a threshold for positivity, with a negative predictive value of >97% for CMV events. CMV events were significantly lower in assay positive vs assay negative patients (3.0% vs 19.5%, P <.0001 for pp65). Time to CMV event post-EOP was significantly greater in those with sfu >40 at EOP (P <.0001). In this large, multicenter trial of kidney transplant recipients, we show that an assessment of CMV-specific immunity using a novel ELISPOT assay is able to predict protection from CMV infection.",
keywords = "T cell biology, clinical research/practice, infection and infectious agents - viral: cytomegalovirus (CMV), infectious disease, kidney transplantation/nephrology",
author = "Deepali Kumar and Peter Chin-Hong and Liise Kayler and David Wojciechowski and Limaye, {Ajit P.} and {Osama Gaber}, A. and Simon Ball and Mehta, {Aneesh K.} and Matthew Cooper and Ted Blanchard and James MacDougall and Kotton, {Camille N.}",
note = "Funding Information: We would like to thank the following investigators who participated in the study: Rajendera Baliga, Tampa General Hospital, Tampa, FL; William Bennett, Legacy Clinical Research, Portland, OR; Daniel Brennan, Washington University (St. Louis), St. Louis, MO; Michael Charlton, Intermountain Medical Center, Murray, UT; Kenneth Chavin, Medical University of South Carolina, Charleston, SC; Peter Chin-Hong, UCSF San Francisco, CA; Ari Cohen, Ochsner Clinic Foundation, New Orleans, LA; Matthew Cooper, Georgetown University, Washington, DC; Osama Gaber, Houston Methodist, Houston, TX; Donald Hricik, University Hospitals Case Medical Center, Cleveland, OH; Shirish Huprikar, Icahn School of Medicine at Mt. Sinai, New York, NY; Hirohito Ichii, University of California, Irvine, Orange., CA; Pradeep Kadambi, University of Arizona, Tucson, AZ; Michelle Lieberman Lubetzky, Montefiore Medical Center, Bronx, NY; Bernard Fischbach, Baylor University Medical Center, Dallas, TX; Arputharaj Kore, Loma Linda University Medical Center, Loma Linda, CA; Deepali Kumar, University Health Network, Toronto, ON; Lisa Kayler, Erie County Medical Center, Buffalo, NY; Ajit Limaye, University of Washington Medical Center, Seattle, WA; Keith Luckett, University of Cincinnati, Division of Nephrology, Cincinnati, OH; Aneesh Mehta, Emory University, Atlanta, GA; Neerja Agrawal and Ignacio Echnique, Cleveland Clinic, Florida, Weston, FL; Robert Naraghi, Transplant Research Institute, Los Angeles, CA; Okechukwu Ojogho, Providence Medical Research, Spokane, WA; Anup Patel, St. Barnabas Medical Center, Livingston, NJ; V. Ram Peddi, California Pacific Medical Center, San Francisco, CA; Alexander Wiseman, Jr. University of Colorado, Denver, Aurora, CO; David Wojciechowski, Massachusetts General, Boston, MA; Carlos Zayas, Georgia Regents University, Augusta, GA; Rachel Hilton, MRC Centre for Transplantation, London, UK; Simon Ball, NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Simon Knight, Nuffield Department of Surgical Sciences, Univ of Oxford; Raj Thuraisingham, Royal London Hospital - Barts Health NHS Trust, Whitechapel, London, UK; Jonathan Bromberg, University of Maryland, Transplant, Baltimore, MD; Michael Ison, Northwestern University, Chicago, IL; Diana Florescu, University of Nebraska, Omaha, NE; Manicar Malinis, Yale University, New Haven, CT; Mark Laftavi, The Research Foundation for SUNY, Syracuse, NY; David Conti, Albany Medical Center, Albany, NY; Ronald Cotton, Baylor College of Medicine, Houston, TX; Jorge Ortiz, University of Toledo Medical Center, Toledo, OH; Richard Baker, Leeds, UK; William McKane, Sheffield, UK. Publisher Copyright: {\textcopyright} 2019 The American Society of Transplantation and the American Society of Transplant Surgeons",
year = "2019",
doi = "10.1111/ajt.15315",
language = "English (US)",
volume = "19",
pages = "2505--2516",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley",
number = "9",
}