Key result
Over 22% of CMV seropositive lung transplant candidates exhibited weak or absent CMV-specific cellular immune responses despite detectable serological memory against CMV.
Why the study?
CMV risk stratification in lung transplantation relies on IgG serology, but weak cellular responses occur in seropositive kidney transplant patients, and the significance in lung transplantation is unknown.
Observational (n=121)
Yes
Effect estimate: Cohen's Kappa 0.409 (95% CI 0.261-0.557)
p-value: p=<0.0001
Over 20% of CMV seropositive lung transplant candidates showed weak CMV-specific cellular immune responses despite detectable serological memory, suggesting serology alone may underestimate post-transplant CMV infection risk.
CMV seropositivity may not ensure cellular immunity in lung transplant candidates; leaves open whether combined testing refines post-transplant risk stratification.
Introduction: Risk stratification for CMV infection in lung transplantation (LT) currently relies on determining donor and recipient CMV IgG before transplantation. However, it has been observed that some patients who test positive for CMV-specific humoral response before kidney transplantation (KT) exhibit a weak or absent CMV-specific cellular response. The significance of this observation in LT is still unknown. Methods: This prospective, multicenter, observational study evaluated the agreement between CMV IgG serology and specific cell-mediated response (specific T cell Enzyme-Linked ImmunoSpot Assay, ELISPOT, against CMV pp65 and IE-1 antigens) in 121 patients on the waiting list for LT. Results: One hundred and four (86%) patients were seropositive for CMV. Discordant humoral and cellular immunologic responses were observed, 29% of seropositive patients had a weak ELISPOT response to IE-1 and 39% to pp65. In 22% of seropositive patients, there was a weak or no response to both antigens. All seronegative patients did not respond to either antigen. Conclusions: Therefore, over 20% of CMV seropositive LT candidates showed weak CMV-specific cellular immune responses despite detectable serological memory against CMV. This may be important in assessing the risk of developing a CMV infection after transplantation.
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Boada-Pérez et al. (2025) conducted an observational in Patients on the waiting list for lung transplantation (n=121). CMV seropositivity (IgG) vs. CMV seronegativity was evaluated on Agreement between CMV IgG serology and specific cell-mediated response (ELISPOT against IE-1) (Cohen's Kappa 0.409, 95% CI 0.261-0.557, p=<0.0001). Over 22% of CMV seropositive lung transplant candidates exhibited weak or absent CMV-specific cellular immune responses despite detectable serological memory against CMV.
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