Cytomegalovirus-Specific Cell-Mediated Immune Responses in Heart and Heart–Lung Transplant Recipients Are Not Predictive for the Occurrence of Symptomatic CMV Disease or Tissue Rejection

Abstract

To study the predictive value of interferon-γ (IFN-γ) production in vitro for the occurrence of symptomatic CMV disease, 17 healthy adult volunteers were tested and 37 heart or heart–lung transplant recipients (CTRs) were studied at various time intervals after transplantation (Tx) for cell-mediated immune (CMI) responses to cytomegalovirus (CMV).

At all intervals post Tx, in vitro IFN-γ production in CTRs was significantly lower than in control subjects. The occurrence of CMV infection was associated with a trend toward inhibited CMI responses prior to the diagnosis, in comparison with CMI responses measured more than 4 weeks prior to or after the diagnosis of CMV infection. The occurrence of acute tissue rejection was associated with a trend toward enhanced CMV responses prior to the diagnosis, on the other hand. In the early post Tx period, the administration of antithymocyte globulin (ATG) or OKT3 monoclonal antibody and peak dosages of azathioprine were associated with significantly inhibited in vitro IFN-γ production.

Despite the demonstrated trends in vitro, IFN-γ production does not appear to be uniformly predictive for the occurrence of symptomatic CMV disease or of acute tissue rejection in CTRs.