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*
Department of Medical Microbiology, The University of Edinburgh Medical School, Edinburgh, United Kingdom;
Department of Infectious and Tropical Diseases, The London School of Hygiene and Tropical Medicine, London, United Kingdom; and
Department of Immunology, Renal, Liver and Bone Marrow Transplant Centres, Royal Free Hospital School of Medicine, Hampstead, London, United Kingdom
EBV-specific autologous CTL were grown in vitro from three adults
(two liver transplant recipients and one patient on hemodialysis
awaiting kidney retransplant). All CTL lines were TCR 
ß, CD8
positive cells, EBV specific, and MHC class I restricted. The CTL lines
were expanded in vitro and infused in three escalating doses (5 x
107, 1 x 108, and 2 x
108) at monthly intervals. Weekly blood samples were
collected following each infusion. EBV-specific CTL precursor cells in
peripheral blood were quantitated by limiting dilution analysis, and
their effect on EBV load in vivo was assessed by semiquantitative PCR.
In all three patients, the numbers of CTL precursor cells increased
during the weeks following the infusions and were highest after the
third infusion. This level gradually declined but remained above the
preinfusion levels for up to 3 mo. EBV genome copy number, on the other
hand, dropped following the first infusion and became undetectable
thereafter. The EBV DNA level remained lower than the pretransplant
level in all patients for up to 3 mo after the last infusion. Our study
shows that it is feasible to generate and expand EBV-specific CTL from
pretransplant blood samples of solid organ transplant recipients, that
these CTL can be stored and infused posttransplant, and that they
remain cytotoxic and EBV specific in vivo. The aim of this study is to
use these CTL for prevention and treatment of lymphoproliferative
disease in solid organ transplant recipients.
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