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
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
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