Does CMV Mismatch Status Modify the Risk of PTLD Due to EBV Mismatch Status in Lung and Heart Transplant Recipients?

Risk factors and clinical outcomes of pediatric liver transplant recipients with post‐transplant lymphoproliferative disease in a multi‐ethnic Asian cohort

“…CMV mismatch and CMV disease have been previously described as risk factors in prior transplant cohorts, and evidence has shown that CMV can have an indirect pathogenic effect in further immunosuppressing an already susceptible transplant recipient by downregulating human leukocyte antigen expression, T‐cell proliferation, and natural killer cell activity . This association between CMV mismatch/CMV disease and PTLD has not been consistently reported, suggesting that other factors, such as the genetic susceptibility of the host, virulence factors of the prevailing virus strains, and the extent of drug‐induced immunosuppression, may influence the purported immunomodulatory mechanisms of the CMV virus. In our cohort, the synergism between CMV naivety and ACR in increasing PTLD risk on stratified analysis may be explained by the combined effects of CMV‐induced and therapeutic immunosuppression, thus increasing the risk of unchecked lymphoproliferation.…”