Dynamics of virus-specific T cell immunity in pediatric liver transplant recipients

R. J. Arasaratnam, I. Tzannou, T. Gray, P. I. Aguayo-Hiraldo, M. Kuvalekar, S. Naik, A. Gaikwad, H. Liu, T. Miloh, J. F. Vera, R. W. Himes, F. M. Munoz, A. M. Leen

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Immunosuppression following solid organ transplantation (SOT) has a deleterious effect on cellular immunity leading to frequent and prolonged viral infections. To better understand the relationship between posttransplant immunosuppression and circulating virus-specific T cells, we prospectively monitored the frequency and function of T cells directed to a range of latent (CMV, EBV, HHV6, BK) and lytic (AdV) viruses in 16 children undergoing liver transplantation for up to 1 year posttransplant. Following transplant, there was an immediate decline in circulating virus-specific T cells, which recovered posttransplant, coincident with the introduction and subsequent routine tapering of immunosuppression. Furthermore, 12 of 14 infections/reactivations that occurred posttransplant were successfully controlled with immunosuppression reduction (and/or antiviral use) and in all cases we detected a temporal increase in the circulating frequency of virus-specific T cells directed against the infecting virus, which was absent in 2 cases where infections remained uncontrolled by the end of follow-up. Our study illustrates the dynamic changes in virus-specific T cells that occur in children following liver transplantation, driven both by active viral replication and modulation of immunosuppression.

Original languageEnglish (US)
Pages (from-to)2238-2249
Number of pages12
JournalAmerican Journal of Transplantation
Issue number9
StatePublished - Sep 2018


  • T cell biology
  • clinical research/practice
  • infectious disease
  • liver transplantation/hepatology
  • monitoring: immune

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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