000099279 001__ 99279
000099279 005__ 20210902121943.0
000099279 0247_ $$2doi$$a10.1093/cid/ciz1209
000099279 0248_ $$2sideral$$a122432
000099279 037__ $$aART-2020-122432
000099279 041__ $$aeng
000099279 100__ $$aJarque, M.
000099279 245__ $$aCellular Immunity to Predict the Risk of Cytomegalovirus Infection in Kidney Transplantation: A Prospective, Interventional, Multicenter Clinical Trial
000099279 260__ $$c2020
000099279 5060_ $$aAccess copy available to the general public$$fUnrestricted
000099279 5203_ $$aBackground: Improving cytomegalovirus (CMV) immune-risk stratification in kidney transplantation is highly needed to establish guided preventive strategies.
Methods: This prospective, interventional, multicenter clinical trial assessed the value of monitoring pretransplant CMV-specific cell-mediated immunity (CMI) using an interferon-γrelease assay to predict CMV infection in kidney transplantation. One hundred sixty donor/recipient CMV-seropositive (D+/R+) patients, stratified by their baseline CMV (immediate-early protein 1)-specific CMI risk, were randomized to receive either preemptive or 3-month antiviral prophylaxis. Also, 15-day posttransplant CMI risk stratification and CMI specific to the 65 kDa phosphoprotein (pp65) CMV antigen were investigated. Immunosuppression consisted of basiliximab, tacrolimus, mycophenolate mofetil, and corticosteroids in 80% of patients, whereas 20% received thymoglobulin induction therapy.
Results: Patients at high risk for CMV based on pretransplant CMI developed significantly higher CMV infection rates than those deemed to be at low risk with both preemptive (73.3% vs 44.4%; odds ratio [OR], 3.44 [95% confidence interval {CI}, 1.30-9.08]) and prophylaxis (33.3% vs 4.1%; OR, 11.75 [95% CI, 2.31-59.71]) approaches. The predictive capacity for CMV-specific CMI was only found in basiliximab-treated patients for both preemptive and prophylaxis therapy. Fifteen-day CMI risk stratification better predicted CMV infection (81.3% vs 9.1%; OR, 43.33 [95% CI, 7.89-237.96]).
Conclusions: Pretransplant CMV-specific CMI identifies D+/R+ kidney recipients at high risk of developing CMV infection if not receiving T-cell-depleting antibodies. Monitoring CMV-specific CMI soon after transplantation further defines the CMV infection prediction risk. Monitoring CMV-specific CMI may guide decision making regarding the type of CMV preventive strategy in kidney transplantation. Clinical Trials Registration: NCT02550639.
000099279 536__ $$9info:eu-repo/grantAgreement/EUR/ERDF/A way to build Europe$$9info:eu-repo/grantAgreement/ES/ISCIII/ICI14-00242$$9info:eu-repo/grantAgreement/ES/ISCIII/PI16-01321
000099279 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000099279 590__ $$a9.079$$b2020
000099279 591__ $$aIMMUNOLOGY$$b18 / 162 = 0.111$$c2020$$dQ1$$eT1
000099279 591__ $$aMICROBIOLOGY$$b12 / 136 = 0.088$$c2020$$dQ1$$eT1
000099279 591__ $$aINFECTIOUS DISEASES$$b3 / 92 = 0.033$$c2020$$dQ1$$eT1
000099279 592__ $$a3.44$$b2020
000099279 593__ $$aMicrobiology (medical)$$c2020$$dQ1
000099279 593__ $$aInfectious Diseases$$c2020$$dQ1
000099279 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000099279 700__ $$aCrespo, E.
000099279 700__ $$aMelilli, E.
000099279 700__ $$0(orcid)0000-0002-2253-7779$$aGutiérrez, A.$$uUniversidad de Zaragoza
000099279 700__ $$aMoreso, F.
000099279 700__ $$aGuirado, L.
000099279 700__ $$aRevuelta, I.
000099279 700__ $$aMontero, N.
000099279 700__ $$aTorras, J.
000099279 700__ $$aRiera, L.
000099279 700__ $$aMeneghini, M.
000099279 700__ $$aTaco, O.
000099279 700__ $$aManonelles, A.
000099279 700__ $$0(orcid)0000-0002-0175-3739$$aPaul, J.$$uUniversidad de Zaragoza
000099279 700__ $$aSeron, D.
000099279 700__ $$aFacundo, C.
000099279 700__ $$aCruzado, J.M.
000099279 700__ $$aGil Vernet, S.
000099279 700__ $$aGrinyó, J.M.
000099279 700__ $$aBestard, O.
000099279 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000099279 773__ $$g71, 9 (2020), 2375-2385$$pClin. infect. dis.$$tCLINICAL INFECTIOUS DISEASES$$x1058-4838
000099279 8564_ $$s468499$$uhttps://zaguan.unizar.es/record/99279/files/texto_completo.pdf$$yPostprint
000099279 8564_ $$s3116452$$uhttps://zaguan.unizar.es/record/99279/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000099279 909CO $$ooai:zaguan.unizar.es:99279$$particulos$$pdriver
000099279 951__ $$a2021-09-02-11:01:50
000099279 980__ $$aARTICLE