Live Cytomegalovirus Vaccination of Renal Transplant Candidates

A Preliminary Trial

  1. JOHN P. GLAZER, M.D.;
  2. HARVEY M. FRIEDMAN, M.D.;
  3. ROBERT A. GROSSMAN, M.D.;
  4. STUART E. STARR, M.D.;
  5. CLYDE F. BARKER, M.D.;
  6. LEONARD J. PERLOFF, M.D.;
  7. ENG-SHANG HUANG, Ph.D.; and
  8. STANLEY A. PLOTKIN, M.D.
  1. Philadelphia, Pennsylvania; and Chapel Hill, North Carolina

    Abstract

    Significant morbidity and mortality are associated with primary cytomegalovirus infections in renal-transplant recipients. In the hope that immunity to cytomegalovirus could safely be established before transplantation, we vaccinated 12 seronegative renal-transplant candidates with the Towne 125 strain of live human cytomegalovirus. Before transplantation, there were no significant reactions except for erythema and induration at the site of inoculation. All vaccinees seroconverted, and the three patients tested acquired a cytomegalovirus-specific cellular immune response. Ten vaccinees underwent transplantation: Nine have completed at least 3 months of follow-up, and eight retain functioning allografts up to 1 year later. Although cytomegalovirus was isolated from six patients after transplantation, the restriction endonuclease patterns of the viral DNA of four of these isolates differed significantly from those of the vaccine strain. Therefore, it appears that the vaccine strain did not become latent in the host, at least in a form that could be reactivated.

    Article and Author Information

    • ▸From the Infectious Diseases Division, The Children's Hospital of Philadelphia, the Infectious Diseases and Renal-Electrolyte Sections. Department of Medicine, and the Transplantation Service, Department of Surgery, Hospital of the University of Pennsylvania, and the Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania; and the Cancer Research Center, University of North Carolina, Chapel Hill, North Carolina.

    • This study was supported by grant AI-14927 from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, and by a grant from Merck and Co., Inc., West Point, Pennsylvania.

    • ▸Requests for reprints should be addressed to John P. Glazer, M.D.; Children's Hospital, 700 Children's Drive; Columbus, OH 43205.

      • Received March 9, 1979.
      • Accepted August 20, 1979.
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    This Article

    1. Ann Intern Med November 1, 1979 vol. 91 no. 5 676-683
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