CMV-associated Immunomodulation in Renal Transplant Patients

Cytomegalovirus (CMV) infection remains one of the most frequent and problematic complications of solid organ transplantation. Several epidemiological studies have shown an association between CMV infection and the occurrence of severe bacterial or fungal infections. However, the mechanisms by which CMV increases the risk of heterologous infection are still poorly understood. Several data support a direct or indirect immunomodulatory effect of CMV. Indeed, in healthy subjects, CMV seropositivity has a strong phenotypic and functional impact on adaptive immunity while in solid organ transplant patients, a decrease in the innate response to various antigenic stimuli has been observed during CMV viremia. The hypothesis of the study is that the occurrence of CMV viremia reduces the ability to develop optimal immune responses against other targeted pathogens in kidney transplant recipients (heterologous immunity). The objective of this project is to identify the immune pathways affected by CMV in the context of immunosuppression associated with kidney transplantation.

Inclusion criteria

• st cohort :

• Age > 18 years
• patients with end-stage renal failure programmed for kidney transplantation with a live donor
• nd cohort :

• Age > 18 years
• kidney transplant recipient with CMV viremia

Exclusion criteria

• Patients under guardianship, curatorship, legal protection.

For patients with end-stage renal failure scheduled to receive a kidney transplant from a living donor :

• Patients with an active viral (other than CMV), bacterial or fungal infection at the time of inclusion
• patients receiving a desensitization protocol (ABO or anti-HLA)