Relevance of graft and donor on CMV transmission in seronegative recipients of solid organ transplantation
Bibliographic record
Abstract
Background. Cytomegalovirus (CMV) is the most important opportunistic pathogen after solid organ transplantation (SOT). For CMV seronegative recipients, the risk of CMV infection transmitted from seropositive donors is up to 50%. The ability of the donor's graft to transmit CMV has been scarcely studied. Methods. A retrospective study (2000–2011) was performed to assess CMV IgG seroconversion in high-risk (CMV D + /R-) adult and pediatric recipients of solid organ transplantation at the University of Alberta Hospital and Stollery Children's Hospital in Edmonton. Results. Out of 409 high risk patients, 284 patients (69%) seroconverted for CMV during follow-up (median 369 days, IQR 205–811) and 65% at two years (figure 1). Almost 70% of patients who seroconverted (198/284) had a positive CMV DNAemia before or 30 days after the first detectable CMV Ig G. The stratified allograft, different rates of seroconversion at 2 years follow-up were observed, with the highest observed for lung and liver transplant recipients (78.6% and 68% respectively); 54% for kidneys and heart patients had the lowest rate (46%) (P = 0.004). Analyzing donors who donated to at least 2 seronegative recipients, 65 donors donated graft to 151 recipients. Fifteen recipients were excluded from this analysis because inadequate follow-up, 57 donors and 128 recipients were therefore analyzed. At 2 years of follow-up, 9 out of 57 donors (16%) did not transmit CMV to any recipient (7 Hearts, 5 Kidneys, 4 Lungs, 3 Livers and 2 others; 2.3 recipients per donor), 21 donors transmitted CMV inconsistently to their different recipients (4/6 hearts, 10/14 lungs, 4/13 kidney, 6/12 liver, 1/4 other) and 27 donors transmitted CMV to all recipients (3 hearts, 11 lungs, 19 kidneys, 18 liver, 6 other). Conclusion. At two years post-transplant, 35% of high-risk recipients did not seroconvert for CMV. The risk of transmission was different among allografts, being higher for lung transplant recipients. Despite recipient characteristics, some donors were less likely to transmit CMV and in up to 16% of donors there was no CMV transmission at two years post-transplant. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".