Association of the outcome of renal transplantation with antibody response to cytomegalovirus strain-specific glycoprotein H epitopes

Clin Infect Dis. 2007 Jul 1;45(1):60-7. doi: 10.1086/518571. Epub 2007 May 23.


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%; P=.005). CMV disease was also more frequently observed in the mismatched group (28% vs. 9%; P=.026). The mismatched group had a higher level of antigenemia (P=.019).

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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Viral / biosynthesis*
  • Antibodies, Viral / immunology
  • Antibody Formation
  • Antibody Specificity
  • Cytomegalovirus / chemistry*
  • Cytomegalovirus Infections / complications*
  • Enzyme-Linked Immunosorbent Assay
  • Graft Rejection / virology
  • Humans
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Transplantation Immunology
  • Viral Envelope Proteins / immunology*


  • Antibodies, Viral
  • Viral Envelope Proteins
  • glycoprotein H, Cytomegalovirus