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Impact of Desensitization on Antiviral Immunity in HLA-Sensitized Kidney Transplant Recipients
Joint Authors
Mirocha, James
Toyoda, Mieko
Shin, Bong-Ha
Ge, Shili
Thomas, David
Chu, Maggie
Rodriguez, Edgar
Chao, Christine
Petrosyan, Anna
Galera, Odette A.
Vo, Ashley
Choi, Jua
Peng, Alice
Kahwaji, Joseph
Jordan, Stanley C.
Source
Journal of Immunology Research
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-24, 24 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-02-06
Country of Publication
Egypt
No. of Pages
24
Main Subjects
Abstract EN
Viral infections represent significant morbidity and mortality factors in kidney transplant recipients, with CMV, EBV, and BKV infections being most common.
Desensitization (DES) with IVIg and rituximab with/without plasma exchange followed by kidney transplantation with alemtuzumab induction increased successful transplant rates in HLA-sensitized patients but may represent an increased risk for viral infections due to severe lymphocyte depletion.
Here, we report on the posttransplant viral infection status in 372 DES versus 538 non-DES patients.
CMV and EBV viremia were significantly lower in DES patients, while BKV viremia was similar.
This trend was observed primarily in CMV sero(−), EBV sero(+), and sero(−) patients.
No patient developed PTLD.
The incidence of BKAN, allograft, and patient survival was similar in both groups.
These viral infections were not associated with subsequent allograft rejection which occurred within 6 months after the infection.
Conclusions.
The IVIg + rituximab desensitization combined with alemtuzumab induction with triple immunosuppression maintenance does not increase the risk for CMV, EBV, and BKV infections.
Possible factors include, in addition to posttransplant antiviral prophylaxis and PCR monitoring, presence of memory T cells and antibodies specific to CMV and likely EBV, NK cell-mediated ADCC despite lymphocyte depletion, elimination of EBV and CMV reservoirs by rituximab and alemtuzumab, and use of IVIg with antiviral properties.
American Psychological Association (APA)
Toyoda, Mieko& Shin, Bong-Ha& Ge, Shili& Mirocha, James& Thomas, David& Chu, Maggie…[et al.]. 2017. Impact of Desensitization on Antiviral Immunity in HLA-Sensitized Kidney Transplant Recipients. Journal of Immunology Research،Vol. 2017, no. 2017, pp.1-24.
https://search.emarefa.net/detail/BIM-1181944
Modern Language Association (MLA)
Toyoda, Mieko…[et al.]. Impact of Desensitization on Antiviral Immunity in HLA-Sensitized Kidney Transplant Recipients. Journal of Immunology Research No. 2017 (2017), pp.1-24.
https://search.emarefa.net/detail/BIM-1181944
American Medical Association (AMA)
Toyoda, Mieko& Shin, Bong-Ha& Ge, Shili& Mirocha, James& Thomas, David& Chu, Maggie…[et al.]. Impact of Desensitization on Antiviral Immunity in HLA-Sensitized Kidney Transplant Recipients. Journal of Immunology Research. 2017. Vol. 2017, no. 2017, pp.1-24.
https://search.emarefa.net/detail/BIM-1181944
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1181944