2011 - ISBTS 2011 Symposium

This page contains exclusive content for the member of the following sections: TTS, ITA

Oral Communications 10: Immune & Infectious Monitoring

11.226 - Cytomegalovirus (CMV) infection in intestinal transplant recipients with NOD2 polymorphism

Presenter: Cal, Matsumoto, Washington, United States
Authors: Cal Matsumoto1, Stuart Kaufman1, Raffaele Girlanda1, Eddie Island1, Cheryl Little1, Kirti Shetty1, Erin Fennelly1, Thomas Fishbein1

Cytomegalovirus (CMV) infection in intestinal transplant recipients with NOD2 polymorphism

Cal Matsumoto, Stuart Kaufman, Raffaele Girlanda, Eddie Island, Cheryl Little, Kirti Shetty, Erin Fennelly, Thomas Fishbein

Transplant Institute, Georgetown University Hospital, Washington, DC, United States

Human CMV infection, a member of the herpes virus family, has routinely been established as a risk factor for increased morbidity and mortality in intestinal transplantation (iTx). Reactivation of latent CMV has been postulated to be a result of an increased proinflammatory state of cytokines and chemokines. In inflammatory bowel disease, a relationship has been established between colitis exacerbations and the reactivation of latent CMV. We have previously demonstrated the association between NOD2 polymorphisms and the abnormal epithelial immune function in iTx recipients. The purpose of this study is to evaluate the relationship between NOD2 mutant iTx recipients and the incidence of CMV infection.

35/134 (25.9%) iTx recipients were identified as having at least one NOD2 polymorphism. 8/35 NOD2 Mutants were CMV serotype matching neg/neg and were excluded from CMV reactivation analysis. Likewise, 50/99 NOD2 Wildtype were neg/neg. 18/35 NOD2 Mutants and 38/99 NOD2 Wildtype had a liver-inclusive intestinal graft. Overall Freedom from CMV was not different between the 2 groups with NOD2 Mutant (69.6%) vs. NOD2 Wildtype (75.3%) p=ns. Recurrent CMV, however, was more prevalent in the NOD2 Mutant group 7/35 vs 4/99 (p=0.019). In evaluation of CMV reactivation (excluding CMV neg/neg matching), no significant difference was noted in overall Freedom from CMV between the 2 groups however, NOD2 mutants in this group had a significantly higher incidence of CMV recurrence than the NOD2 Wildtype, 7/27 vs. 4/47 respectively, (p = 0.04).

NOD2 Mutation in iTx recipients appears to play a role in the incidence of CMV recurrence after initial CMV infection. Perhaps an chronically altered and dysregulated inflammatory state in the NOD2 Mutant iTx recipient plays an important role in the increased recurrence of CMV infection in this population. A role for a more aggressive CMV prophylaxis in this subset of iTx recipients appears warranted.

Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.



Staff Directory
This email address is being protected from spambots. You need JavaScript enabled to view it.


The Transplantation Society
International Headquarters
505 Boulevard René-Lévesque Ouest
Suite 1401
Montréal, QC, H2Z 1Y7