Abstract
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 language | English (US) |
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Pages (from-to) | 2238-2249 |
Number of pages | 12 |
Journal | American Journal of Transplantation |
Volume | 18 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2018 |
Keywords
- T cell biology
- clinical research/practice
- infectious disease
- liver transplantation/hepatology
- monitoring: immune
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)