%0 Journal Article
%A Fernandez-Ruiz, M
%A Gimenez, E
%A Vinuesa, V
%A Ruiz-Merlo, T
%A Parra, P
%A Amat, P
%A Montejo, M
%A Paez-Vega, A
%A Cantisan, S
%A Torre-Cisneros, J
%A Fortun, J
%A Andres, A
%A San Juan, R
%A Lopez-Medrano, F
%A Navarro, D
%A Aguado, J M
%T Regular monitoring of cytomegalovirus-specific cell-mediated immunity in intermediate-risk kidney transplant recipients: predictive value of the immediate post-transplant assessment.
%D 2018
%U http://hdl.handle.net/10668/12511
%X Previous studies on monitoring of post-transplant cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) are limited by single-centre designs and disparate risk categories. We aimed to assess the clinical value of a regular monitoring strategy in a large multicentre cohort of intermediate-risk kidney transplant (KT) recipients. We recruited 124 CMV-seropositive KT recipients with no T-cell-depleting induction pre-emptively managed at four Spanish institutions. CMV-specific interferon-γ-producing CD4+ and CD8+ T cells were counted through the first post-transplant year by intracellular cytokine staining after stimulation with pp65 and immediate early-1 peptides (mean of six measurements per patient). The primary outcome was the occurrence of any CMV event (asymptomatic infection and/or disease). Optimal cut-off values for CMV-specific T cells were calculated at baseline and day 15. Twelve-month cumulative incidence of CMV infection and/or disease was 47.6%. Patients with pre-transplant CMV-specific CD8+ T-cell count  Monitoring for CMV-specific CMI in intermediate-risk KT recipients must be regular to reflect dynamic changes in overall immunosuppression and individual susceptibility. The early assessment at post-transplant day 15 remains particularly informative.
%K Cell-mediated immunity
%K Cytomegalovirus
%K Immune monitoring intracellular cytokine staining
%K Kidney transplantation
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