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Immunity after Organ Transplant - A Primer for the Clinician
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TLDR
Several techniques are now available to quantify CMV-specific T-cell responses, including flow cytometry, enzyme- linked immunosorbent spot assay, and enzyme-linked immunOSorbent assay, which have the potential to significantly change the monitoring and treatment of CMV.Abstract:
Cytomegalovirus (CMV) is one of the most common infections after solid organ transplantation. Improved assays to predict viral replication and disease would help refine current preventive strategies. Monitoring of CMV-specific T-cell responses may help guide clinical decision making. Several techniques are now available to quantify CMV-specific T-cell responses, including flow cytometry, enzyme-linked immunosorbent spot assay, and enzyme-linked immunosorbent assay. Standardization and validation of these assays have the potential to significantly change the monitoring and treatment of CMV and further personalize CMV prevention strategies. In this review, we discuss the measurement of CMV-specific T-cell responses and their clinical impact on the management of CMV after organ transplantation.read more
Citations
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Journal ArticleDOI
The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation
Camille N. Kotton,Deepali Kumar,Angela M. Caliendo,Shirish Huprikar,Sunwen Chou,Lara Danziger-Isakov,Atul Humar +6 more
TL;DR: Highlights include advances in molecular and immunologic diagnostics, improved understanding of diagnostic thresholds, optimized methods of prevention, advances in the use of novel antiviral therapies and certain immunosuppressive agents, and more savvy approaches to treatment resistant/refractory disease.
Journal ArticleDOI
Cytomegalovirus infections in solid organ transplantation: a review.
TL;DR: An overview of the contemporary epidemiology, clinical presentation, diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients is provided.
Journal ArticleDOI
Cytomegalovirus infection in transplant recipients
Luiz Sergio Azevedo,Lígia Camera Pierrotti,Edson Abdala,Silvia Figueiredo Costa,Tânia Mara Varejão Strabelli,Silvia Vidal Campos,Jessica Fernandes Ramos,Acram Zahredine Abdul Latif,Nadia Litvinov,Natalya Zaidan Maluf,Helio Hehl Caiaffa Filho,Cláudio Sérgio Pannuti,Marta Heloísa Lopes,Vera Aparecida dos Santos,Camila da Cruz Gouveia Linardi,Maria Aparecida Shikanai Yasuda,Heloisa Helena de Sousa Marques +16 more
TL;DR: Cytomegalovirus infection is a frequent complication after transplantation and can be prevented by prophylaxis or by preemptive therapy (the early diagnosis of viral replication before development of the disease and prescription of antiviral treatment to prevent the appearance of clinical disease).
Journal ArticleDOI
Biomarkers for kidney transplant rejection
TL;DR: Although the growing understanding of organ rejection has provided numerous candidate biomarkers, none has been confirmed in robust validation studies as sufficiently useful to guide clinical practice independent of traditional clinical methods.
Journal ArticleDOI
Clinical immune-monitoring strategies for predicting infection risk in solid organ transplantation.
TL;DR: Clinical evidence to date supporting the use of approaches to the post‐transplant immune status, based on interferon‐γ release assays, intracellular cytokine staining or main histocompatibility complex‐tetramer technology is summarized.
References
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Journal ArticleDOI
T cell exhaustion
TL;DR: Advances in the molecular delineation of T cell exhaustion are clarifying the underlying causes of this state of differentiation and also suggest promising therapeutic opportunities.
Journal ArticleDOI
The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation
Camille N. Kotton,Deepali Kumar,Angela M. Caliendo,Shirish Huprikar,Sunwen Chou,Lara Danziger-Isakov,Atul Humar +6 more
TL;DR: Highlights include advances in molecular and immunologic diagnostics, improved understanding of diagnostic thresholds, optimized methods of prevention, advances in the use of novel antiviral therapies and certain immunosuppressive agents, and more savvy approaches to treatment resistant/refractory disease.
Journal ArticleDOI
Broadly targeted human cytomegalovirus-specific CD4+ and CD8+ T cells dominate the memory compartments of exposed subjects
Andrew W. Sylwester,Bridget L. Mitchell,John B. Edgar,Cara Taormina,Christian Pelte,Franziska Ruchti,Paul R. Sleath,Kenneth H. Grabstein,Nancy Ann Hosken,Florian Kern,Jay A. Nelson,Louis J. Picker +11 more
TL;DR: The first glimpse of the total human T cell response to a complex infectious agent is provided and insight into the rules governing immunodominance and cross-reactivity in complex viral infections of humans is provided.
Journal ArticleDOI
Efficacy and safety of valganciclovir vs. oral ganciclovir for prevention of cytomegalovirus disease in solid organ transplant recipients.
Carlos V. Paya,Atul Humar,Ed Dominguez,Kenneth Washburn,Emily A. Blumberg,Barbara D. Alexander,Richard B. Freeman,Nigel Heaton,Mark D. Pescovitz +8 more
TL;DR: Once‐daily oral valganciclovir was as clinically effective and well‐tolerated as oral ganciclovIR tid for CMV prevention in high‐risk SOT recipients and the safety profile was similar for both drugs.
Journal ArticleDOI
Cytotoxic t cells in cytomegalovirus infection: HLA-restricted T-lymphocyte and non-T-lymphocyte cytotoxic responses correlate with recovery from cytomegalovirus infection in bone-marrow-transplant recipients.
Gerald V. Quinnan,Nigar Kirmani,Alain H. Rook,Jody Manischewitz,Lozannie Jackson,Gail Moreschi,George W. Santos,Rein Saral,William H. Burns +8 more
TL;DR: The correlation between effective virus-specific cytotoxic response and recovery from infection indicates that these effector cells probably mediate recovery from cytomegalovirus infection.