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Blood, 1 January 2006, Vol. 107, No. 1, pp. 389-396.
Prepublished online as a Blood First Edition Paper on September 20, 2005; DOI 10.1182/blood-2005-07-2746.
 Previous Article | Next Article 
Submitted July 11, 2005
Accepted August 26, 2005
The pre-transplant CMV-specific T-cells protect recipients of T-cell depleted grafts against cytomegalovirus related complications
Yves Chalandon, Sylvie Degermann, Jean Villard, Lionel Arlettaz, Laurent Kaiser, Solange Vischer, Steffen Walter, Mirjam H Heemskerk, Rene A van Lier, Claudine Helg, Bernard Chapuis, and Eddy Roosnek*
Division of Hematology, Department of Internal Medecine, University Hospital Geneva, Geneva, Switzerland
Division of Immunology and Allergology, Department of Internal Medecine, University Hospital Geneva, Geneva, Switzerland
Division of Infectious Diseases, Department of Internal Medecine, University Hospital Geneva, Geneva, Switzerland
Institute for Cell Biology, Department of Immunology, Eberhard Karls University, Tuebingen, Germany
Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
Laboratory of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
* Corresponding author; email: roosnek{at}medecine.unige.ch.
We have studied CMV-immunity in 17 CMV-positive recipients of T-cell depleted or T-cell repleted grafts. In recipients of T-cell repleted grafts, the patient's CMV-specific T-cell response was completely ablated. Because primary anti-CMV responses were rare during the first year, immunity depended essentially on the transfer of donor CMV-specific T-cells and therefore on the CMV-positivity of the donor. In the recipients of T-cell depleted grafts, CMV-specific cytotoxic T-cells were of recipient origin in 2 patients transplanted with a CMV-negative donor as well as in 3/8 patients transplanted with a CMV-positive donor and of mixed- or donor origin in the other 5 patients studied. Recipient CMV-specific T-cells responded vigorously to antigen ex vivo and persisted for several years without being replenished by donor cells. Furthermore, they appeared to have a protective effect as CMV-related complications were absent in the patients with CMV-specific T-cells of recipient origin. The clinical outcome of a cohort of 91 patients corroborated the experimental results. Patients with recipient T-cells in their blood were protected regardless of the donor immune status. Hence, when a T-cell depletion protocol is used that favors the survival of recipient T-cells, the patient's pre-transplant CMV-specific immunity protects against post-transplant CMV-related complications.
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