CMV-specific T-cell immunity in kidney transplantation. Monitoring the CMV-specific T-cell response: pre and post-transplant
Martínez-Férez IM, Rodríguez-López R, Benot-Lopez S.
Record ID 32018000390
Spanish
Original Title:
Inmunidad celular específica a CMV en trasplante renal. Utilidad de la monitorización de la inmunidad específica a CMV: pre y postrasplante. Revisión sistemática
Authors' objectives:
To assess the clinical validity and utility of monitoring CMV-specific cellular immune response in renal transplant patients. Health outcomes (reduction of morbidity / disease by CMV) and / or the impact on the therapeutic decision were considered in two different indications:
1. Pre-transplant: as a complement to the serology in the classification of the risk of infection of the patients before the renal transplant.
2. Post-transplant in the monitoring of high risk patients (D + / R-) after prophylactic treatment.
Authors' results and conclusions:
Pre-transplant
• CMV-specific cellular immune response assays using INF- analysis are under investigation. The most appropriate epitopes and the higher capacity points of discrimination in the two tested techniques (ELISpot-assay and ICS) are being evaluated
• ELISpot-assay and ICS tests have shown low sensitivity and high specificity; although positive and negative likelihood ratios indicated the tests did not provide meaningful diagnostic information on the risk of CMV infection.
• The clinical utility of CMV-specific CD4 + and CD8 + monitoring remain unclear.
Post-transplant in D+/R- patients
• The major risk factor for CMV infection and / or disease appears to be the serological status of the donor and graft recipient.
• No association between CMV-specific CD4 + and CD8 + cell (ICS) levels and the infection or disease in renal transplantation was found; although the evidence proceeded from a single study with methodological limitations.
• There is no evidence on the clinical utility of monitoring CMV-specific cellular immune response (CD4 + and CD8 +) in this indication.
Details
Project Status:
Completed
Year Published:
2017
URL for published report:
https://www.aetsa.org/publicacion/inmunidad-celular-especifica-a-cmv-en-trasplante-renal-utilidad-de-la-monitorizacion-de-la-inmunidad-especifica-a-cmv-pre-y-postrasplante-revision-sistematica/
Requestor:
Health Ministry of Spain
English language abstract:
An English language summary is available
Publication Type:
Mini HTA
Country:
Spain
MeSH Terms
- Kidney Transplantation
- Cytomegalovirus Infections
- Treatment Outcome
Contact
Organisation Name:
Andalusian Health Technology Assessment Area
Contact Address:
Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309
Contact Name:
aetsa.csalud@juntadeandalucia.es
Contact Email:
aetsa.csalud@juntadeandalucia.es
Copyright:
Andalusian Health Technology Assessment Area
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.