Association of the Outcome of Renal Transplantation with Antibody Response to Cytomegalovirus Strain–Specific Glycoprotein H Epitopes
Departments of 1Microbiology and 2Urology, Fukushima Medical University, Fukushima, and 3Department of Urology, Tokyo Women’s Medical University, and 4Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
Background.
Cytomegalovirus (CMV) is the most important pathogen affecting the outcome of renal transplantation. The combination of CMV‐seronegative transplant recipients with CMV‐seropositive transplant donors places recipients at the highest risk of CMV disease. In cases of congenital CMV infection, existing immunity only partially protected mothers from reinfection with a different genotypic strain. The effect of differences in infected CMV strains between CMV‐seropositive transplant donors and CMV seropositive transplant recipients on the outcome of transplantation remains unclear.
Methods.In this prospective multicenter study, the presence of antibodies against strain‐specific glycoprotein H epitopes in 84 CMV‐seropositive transplant donor/CMV‐seropositive transplant recipient renal transplantation cases were determined, and their relationships to acute transplant rejection, CMV infection, degree of antigenemia, and CMV disease were evaluated.
Results.Among the 84 donor/recipient pairs, 45 and 32 had matched and mismatched strain‐specific glycoprotein H antibodies, respectively. Acute transplant rejection in the mismatched group was more frequent than it was in the matched group (63% vs. 22%; 
). CMV disease was also more frequently observed in the mismatched group (28% vs. 9%; 
). The mismatched group had a higher level of antigenemia (
).
Conclusions.Our results illustrate more adverse events in the cases with a CMV‐seropositive transplant donor and a CMV‐seropositive transplant recipient in which the glycoprotein H antibodies are mismatched, suggesting that reinfection with a different CMV strain results in more complications.
Received 30 January 2007; accepted 9 March 2007; electronically published 23 May 2007.
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Online publication date: 1-Aug-2009.
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Presented in part: 100th Annual Meeting of the American Urological Association, San Antonio, Texas, 21–26 May 2005 (abstract 1625); 12th International Conference on Immunobiology and Prophylaxis of Human Herpesvirus Infections, Osaka, Japan, 6–8 October 2005 (abstract P‐15); and 26th International Herpesvirus Workshop, Seattle, Washington, 22–28 July 2006 (abstract 3.20).