CMV specific T cell immunity predicts early viremia after liver transplantation.

BACKGROUND: Cytomegalovirus (CMV) infection is one of the most important factors affecting liver transplant with direct and indirect effects. However, CMV disease after transplant remains poorly predicted.

OBJECTIVE: In this study, preoperative CMV-specific cell-mediated immunity was evaluated in recipients of liver transplant in Korea, where most people are seropositive.

METHODS: A total of 32 patients were enrolled in a prospective study, and blood samples were collected before liver transplant to determine CMV-specific cell-mediated immunity. Testing using ELiSpot IFN-γ (CMVspot) and CMV serology were performed simultaneously.

RESULTS: CMVspot results showed that 30 recipients had CMV-specific cell-mediated immunity, of which 29 were positive for phosphoprotein 65 and 14 for immediate early protein 1 (IE-1). All patients were positive for CMV IgG before transplantation, and 17 patients had a CMV viremia episode after transplantation. CMVspot showed 100% specificity and positive predictive value, and 11.76% sensitivity to predict CMV viremia. Patients with positive or borderline results for IE-1 did not show viremia two months after transplantation (p = .041).

CONCLUSION: CMVspot may be helpful in establishing a treatment strategy that includes regular monitoring for risk stratification of CMV reactivation.