Table 1.
Baseline characteristics of patients.
Fig 1.
QF-CMV results at pretransplant, post-transplant 1 month, and post-transplant 3 months in recipients with post-KT CMV DNAemia (-) and CMV DNAemia (+) by Pearson uncorrected Chi-square test.
There was no significant difference in frequencies of QF-CMV positivity between two groups. NS, not significant (P > 0.05).
Fig 2.
Results of pp65- and IE-1 specific ELISPOT at pretransplant, post-transplant 1 month, and post-transplant 3 months in recipients with post-KT CMV DNAemia (-) and CMV DNAemia (+) by Mann-Whitney U test.
(A) For pp65-ELISPOT, patients with CMV DNAemia (+) had significantly lower response at post-transplant 1 month than patients with CMV DNAemia (-) [median (95% CI): 8.5 (1.4–130.5) vs. 138.0 (87.2–214.7), P = 0.016]. (B) For IE-1-ELISPOT, CMV DNAemia (+) patients showed significantly lower response at post-transplant 1 and 3 months compared to CMV DNAemia (-) patients (4.0 (1.0–8.1) vs. 18.0 (8.0–44.0), P = 0.019 and 2.0 (0.0–46.6) vs. 27.0 (13.0–56.4), P = 0.014, respectively).
Fig 3.
Plot versus criterion value curves for the post-transplant 1 month pp65-ELISPOT and IE-1-ELISPOT assay for predicting CMV DNAemia.
The X-axis shows the cut-off spots/200,000 cells and the Y-axis shows the percentage of CMV DNAemia development. The sensitivity and specificity of pp65-ELISPOT at post-transplant 1 month for predicting CMV DNAemia were 70.0% (95% CI: 34.8–93.3) and 72.2% (95% CI: 60.4–82.1%) with a cut-off value of ≤ 30 spots/200,000 cells. IE-1-ELISPOT showed a sensitivity of 90.0% (95% CI: 55.5–99.7%) and a specificity of 54.7% (95% CI: 42.7–66.2%) to predict CMV DNAemia with a cut-off value of ≤ 10 spots/200,000 cells.
Table 2.
Diagnostic accuracy of post-transplant 1 month CMV ELISPOT assay for predicting CMV DNAemia with ROC analysis.
Fig 4.
Kaplan–Meier analysis according to the CMV ELISPOT response.
Kaplan-Meier failure estimate showing that patients with high response of CMV ELISPOT at post-transplant 1 month had lower development of CMV DNAemia than patients with low response of CMV ELISPOT (P = 0.019). Patients were classified into high response (if the either pp65 or IE-1 antigens had spot counts more than the cut-off thresholds) and low response CMV (if level of both antigens were below the cut-off thresholds) post-KT 1 month CMV ELISPOT assay.