CMV-specific T Cell Monitoring Offers Superior Risk Stratification of CMV-seronegative Kidney Transplant Recipients of a CMV-seropositive Donor.

Background: Detectable CMV-specific T cells in CMV-seronegative kidney transplant recipients (KTRs) have been attributed to an absence of circulating antibodies despite CMV-sensitization. The diagnostic value of CMV-specific T cells, however, needs to be implemented in risk stratification for CMV-replication. Methods: 326 KTRs were studied and classified with respect to CMV-serostatus and presence of CMV-specific T cells. Samples were collected pretransplantation, at +1, +2, and +3 months posttransplantation. CMV-specific T cells directed to CMV-IE1 and CMV-pp65 were measured by interferon-[gamma] Elispot assay. Results: 19/67 D+R- KTRs (28%) showed pretransplant CMV-specific T cells. Although no differences were observed for CMV-replication, KTRs with CMV-specific T cells presented with lower initial and peak CMV-loads (p

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