Create the test that predicts the risk of infection in kidney transplants

Source: www.immedicohospitalario.es

The clinical efficacy of this new diagnosed tool has been tested in five hospitals with clinical trials, which is a step towards personalized medicine in the field of transplants.

The Renal Transplant Unit of the Nephrology Service of Bellvitge University Hospital has developed and demonstrated the efficacy of a new immunological test to prevent one of the most frequent and serious opportunistic infections after a transplant, such as cytomegalovirus. This information derives from the good results obtained by applying this test in a study published Thursday by the scientific journal Clinical Infectious Diseases.

The clinical efficacy study has been coordinated by researchers from the Bellvitge University Hospital and the Bellvitge Biomedical Research Institute (IDIBELL) and the Vall d´Hebron University Hospital, the Puigvert Foundation, the Clinical Hospital of Barcelona and the Hospital have also participated Miguel Servet University of Zaragoza. The work has included the follow-up of 160 patients over a period of twelve months.

Opportunistic cytomegalovirus infection is the most frequent and also the most serious – to the point that it can be fatal – among patients who have received a kidney transplant. For this reason, until now all transplanted people were treated preventively against this virus in a generalized way. This therapy, however, is not harmless, as it has toxic effects and can also interfere with the management of immunosuppressive treatment and put at risk of rejection of the transplanted organ.

The realization of this test, designed by researchers from Bellvitge University Hospital and IDIBELL, would avoid prescribing this antiviral therapy when it is not necessary. The test is applied to patients who have just received a kidney transplant and examines how T lymphocytes (blood cells involved in the immune response) respond to cytomegalovirus. If it is established that the patient has a good immune response to cytomegalovirus, the preventive antiviral treatment against this infectious agent can be saved.

Dr. Oriol Bestard, head of the Renal Transplant Unit of the Bellvitge University Hospital and one of the main authors of the study, shows that it is the first time worldwide that the clinical efficacy of a test to prevent Cytomegalovirus infection in a randomized, prospective, intervention clinical trial. As he emphasizes, “it is a step towards personalized medicine, in which therapeutic decisions are directed according to the individual risk of each patient.” He also states that this advance “can significantly change transplant medicine, since it will avoid unnecessary toxic treatments while saving significant economic costs”.

The study has been conducted with patients who have received a kidney transplant, but the researchers point out that it is an equally useful test to help prevent the same infection in other solid organ transplants, as well as in patients who receive a bone marrow transplant, although additional studies are needed in these latter scenarios to prove their effectiveness, some of them already underway and also led from Bellvitge Hospital.

From these data, it is expected to start using this new technology in a protocolized way in the usual clinical practice in a short period of time.

A step forward thanks to a test that predicts the risk of infection in kidney transplants.

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