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- Title
Association of the Outcome of Renal Transplantation with Antibody Response to Cytomegalovirus Strain—Specific Glycoprotein H Epitopes.
- Authors
Ishibashi, Kei; Tokumoto, Tadahiko; Tanabe, Kazunari; Hiroki Shirakawa; Hashimoto, Koichi; Kushida, Nobuhiro; Yanagida, Tomohiko; Inoue, Naoki; Yamaguchi, Osamu; Toma, Hiroshi; Suzutani, Tatsuo
- Abstract
Background. Cytomegalovirus (CMV) is the most important pathogen affecting the outcome of renal transplantation. The combination of CMV-seronegative transplant recipients with CMV-seropositive transplant donors places recipients at the highest risk of CMV disease. In cases of congenital CMV infection, existing immunity only partially protected mothers from reinfection with a different genotypic strain. The effect of differences in infected CMV strains between CMV-seropositive transplant donors and CMV seropositive transplant recipients on the outcome of transplantation remains unclear. Methods. In this prospective multicenter study, the presence of antibodies against strain-specific glycoprotein H epitopes in 84 CMV-seropositive transplant donor/CMV-seropositive transplant recipient renal transplantation cases were determined, and their relationships to acute transplant rejection, CMV infection, degree of antigenemia, and CMV disease were evaluated. Results. Among the 84 donor/recipient pairs, 45 and 32 had matched and mismatched strain-specific glycoprotein H antibodies, respectively. Acute transplant rejection in the mismatched group was more frequent than it was in the matched group (63% vs. 22%; P = .005). CMV disease was also more frequently observed in the mismatched group (28% vs. 9%; P = .026). The mismatched group had a higher level of antigenemia (P = 0.19).Conclusions. Our results illustrate more adverse events in the cases with a CMV-seropositive transplant donor and a CMV-seropositive transplant recipient in which the glycoprotein H antibodies are mismatched, suggesting that reinfection with a different CMV strain results in more complications.
- Subjects
CYTOMEGALOVIRUS diseases; GLYCOPROTEINS; KIDNEY diseases; TRANSPLANTATION of organs, tissues, etc.; GRAFT rejection; INFECTION
- Publication
Clinical Infectious Diseases, 2007, Vol 45, Issue 1, p60
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1086/518571