Immunopathological analysis of influence of cytomegalovirus to acute rejection after renal transplantation

2005 Fiscal Year Final Research Report Summary

• Project/Area Number: 16591609
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Urology
• Research Institution: Fukushima Medical University
• Principal Investigator: ISHIBASHI Kei Fukushima Medical University, Department of Microbiology, Assistant Professor, 医学部, 助手 (90347211)
• Co-Investigator(Kenkyū-buntansha): TOMA Hiroshi Tokyo Women's Medical University, Department of urology, Professor, 腎臓病総合医療センター, 教授 (90075549) ; SUZUTANI Tatsuo Fukushima Medical University, Department of Microbiology, Professor, 医学部, 教授 (40196895) ; YANAGIDA Tomohiko Fukushima Medical University, Department of Urology, Assistant Professor, 医学部, 助手 (20363765)
• Project Period (FY): 2004 – 2005
• Keywords: renal transplantation / cytomegalovirus / acute rejection / antigenemia / glycoprotein H

Research Abstract

1.BACKGROUND : The impact of cytomegalovirus (CMV) superinfection with different serotypes on renal transplantation and the differences between CMV superinfection and primary infection or reactivation are still unknown.
2.METHODS : Serum samples from 114 renal transplant recipients and the 114 donors were analyzed for serotype specific antibodies against a CMV glycoprotein epitope. The pairings were categorized into CMV primary infection, superinfection and reactivation groups according to their antibody responses. We examined the association between CMV-infection type and acute rejection and CMV disease.
3.RESULTS : Among the 114 renal transplant pairings, 24 were categorized into the primary infection group, 48 into the reactivation group and 26 into the superinfection group according to serotype specific antibodies titers. The viral load of recipients quantified using pp65 antigenemia assay after transplantation were significantly higher in the superinfection and primary infection groups compared with that in the reactivation group (p<0.0001). The rate of CMV disease in antigenemia-positive cases was also significantly higher in the primary infection and superinfection groups compared with that in the reactivation group (P=0.006 and P=0.013, respectively). However, the rate of acute rejection was higher in the superinfection group (62 percent) compared with primary infection group (25 percent)(P=0.008, Fisher's exact test) and reactivation group (23 percent)(P=0.001).
4.CONCLUSIONS : Preoperative grouping of CMV infection by serotype specific antibodies can predict the risk of acute rejection as well as CMV disease after renal transplantation.