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丙型肝炎病毒阴性肾移植受者接受丙型肝炎病毒血症供体和丙型肝炎病毒血症供体移植后的 CMV 特异性 T 细胞免疫反应。

CMV specific T cell immune response in hepatitis C negative kidney transplant recipients receiving transplant from hepatitis C viremic donors and hepatitis C aviremic donors.

机构信息

Department of Medicine, Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.

出版信息

Ren Fail. 2022 Dec;44(1):831-841. doi: 10.1080/0886022X.2022.2072744.

Abstract

Kidney transplants (KT) from hepatitis C (HCV) viremic donors to HCV negative recipients has shown promising renal outcomes, however, high incidence of cytomegalovirus (CMV) viremia were reported. We performed a prospective cohort study of 52 HCV negative KT recipients from Methodist University Hospital including 41 receiving transplants from HCV aviremic donors and 11 from HCV viremic donors. CMV specific CD4+ and CD8 + T cell immunity was measured by intracellular flow cytometry assay. Primary outcome was the development of positive CMV specific CD4+ and CD8 + T cell immune response in the entire cohort and each subgroup. The association between donor HCV status and CMV specific CD4+ and CD8 + T cell immune response was analyzed by Cox proportional hazard models. Mean recipient age was 48 ± 13 years, with 73% male and 82% African American. Positive CMV specific CD4+ and CD8 + T cell immune response was found in 53% and 47% of the cohort at 1 month, 65% and 70% at 2 months, 80% and 75% at 4 months, 89% and 87% at 6 months, and 94% and 94% at 9 months post-transplant, respectively. There was no significant difference in the incidence of positive CMV specific T cell immune response between recipients of transplants from HCV aviremic donors compared to HCV viremic donors in unadjusted (for CD8+: HR = 1.169, 95%CI: 0.521-2.623; for CD4+: HR = 1.208, 95%CI: 0.543-2.689) and adjusted (for CD8+: HR = 1.072, 95%CI: 0.458-2.507; for CD4+: HR = 1.210, 95%CI: 0.526-2.784) Cox regression analyses. HCV viremia in donors was not associated with impaired development of CMV specific T cell immunity in this cohort.

摘要

从丙型肝炎(HCV)病毒血症供体向 HCV 阴性受者进行肾脏移植(KT)已显示出有前景的肾脏结局,但据报道巨细胞病毒(CMV)病毒血症的发生率较高。我们对包括 41 例接受 HCV 非病毒血症供体移植和 11 例接受 HCV 病毒血症供体移植的 52 例 HCV 阴性 KT 受者进行了一项前瞻性队列研究。通过细胞内流式细胞术检测 CMV 特异性 CD4+和 CD8+T 细胞免疫。主要结局是整个队列和每个亚组中 CMV 特异性 CD4+和 CD8+T 细胞免疫应答的发展。通过 Cox 比例风险模型分析供体 HCV 状态与 CMV 特异性 CD4+和 CD8+T 细胞免疫应答的关系。平均受者年龄为 48±13 岁,男性占 73%,非洲裔美国人占 82%。在移植后 1 个月时,队列中有 53%和 47%的患者出现 CMV 特异性 CD4+和 CD8+T 细胞免疫应答,2 个月时分别为 65%和 70%,4 个月时分别为 80%和 75%,6 个月时分别为 89%和 87%,9 个月时分别为 94%和 94%。在未调整(CD8+:HR = 1.169,95%CI:0.521-2.623;CD4+:HR = 1.208,95%CI:0.543-2.689)和调整(CD8+:HR = 1.072,95%CI:0.458-2.507;CD4+:HR = 1.210,95%CI:0.526-2.784)的 Cox 回归分析中,HCV 非病毒血症供体与 CMV 特异性 T 细胞免疫的发育受损无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/106b/9103398/db1508ee2c8e/IRNF_A_2072744_F0001_B.jpg

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