A new clinical and immuno-virological score for predicting the risk of late severe infection in solid organ transplant recipients: the CLIV Score

BACKGROUND: We aimed at constructing a composite score based on EBVd and simple clinical and immunological parameters to predict late severe infection (LI) beyond month 6 in SOT recipients. METHODS: Kidney and liver transplant recipients between May 2014-August 2016 at four participating centers were included. Serum immunoglobulins and complement factors, peripheral blood lymphocyte subpopulations, and whole-blood EBVd were determined at months 1, 3 and 6. Cox regression analyses were performed to generate a weighted score for the prediction of LI. RESULTS: Overall, 309 SOT recipients were followed-up for a median of 1,000 days from transplant (IQR: 822-1124). LI occurred in 104 patients (33.6%). The CLIV score consisted of the following variables at month 6: high-level EBVd (>1,500 IU/ml) and recurrent infection during the previous months (6 points); recipient age >/=70 years and chronic graft dysfunction (5 points); CMV mismatch (4 points); and CD8+ T-cell count /=10: 73.5%. CONCLUSIONS: Awaiting further external validation, CLIV-score based on clinical and immune-virological parameters is potentially useful to stratify the risk of LI after SOT.