Significance of immune cell function monitoring in renal transplantation after Thymoglobulin induction therapy

Serban, George; Whittaker, Vaughn; Fan, Jason; Liu, Zhouru; Manga, Kiran; Khan, M S; Kontogianni, Katerina; Padmanabhan, Anand; Cohen, David J.; Suciu‐Foca, Nicole; Ratner, Lloyd E.; Colovai, Adriana I.

doi:10.1016/j.humimm.2009.07.027

Cited by 54 publications

(37 citation statements)

References 40 publications

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“…As reported, the Cylex ImmuKnow assay has a high predictive value and provides a target immunological response level for minimizing the risk of post-transplant infection and rejection in solid organ transplantation (Kowalski et al 2006;Husain et al 2009;Bhorade et al 2008). However, a few studies have indicated that the immune function assay has a very limited role in assessing the risk of infection or rejection in cardiac transplant recipients (Gupta et al 2008;Rossano et al 2009) and the risk of rejection in renal transplantation after Thymoglobulin induction therapy (Serban et al 2009). In our ROC analysis, we found that the immune function assay was helpful in the diagnosis of infection and rejection with acceptable levels of sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma

Shi

Fan

Huang

et al. 2011

J Cancer Res Clin Oncol

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Section: Discussionmentioning

confidence: 99%

An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma

Shi

Fan

Huang

et al. 2011

J Cancer Res Clin Oncol

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“…6 Low ATP levels can identify patients at an increased risk for infection, but high ATP values do not correlate with rejection in kidney transplant recipients who receive antithymocyte globulin induction therapy. 10 In addition, ATP levels < 100 ng/mL obtained with this kit within 1 month of infection may be an independent predictor for the development of infection syndromes in lung transplant recipients. 11 Infection with BK virus may be associated with low ATP levels at 12 months after kidney transplant.…”

Section: Characteristicmentioning

confidence: 93%

“…[6][7][8][9][10][11][12] This assay also may assess cell-mediated immunity and can be used to titrate initial reduction and subsequent increase of immunosuppression in patients who have a viral infection after kidney transplant. 9 High ATP values detected by the kit that was used in the present study may not confirm an increased risk of acute rejection episodes, but this assay has been used to assess the risk of infection in patients who have posttransplant lympho-proliferative disease caused by CMV infection.…”

Section: Characteristicmentioning

confidence: 99%

Untitled

2014

Exp Clin Transplant

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Objectives: The adenosine triphosphate assay using peripheral lymphocytes may be useful to evaluate the risks of acute rejection and infection in kidney transplant patients. We used the adenosine triphosphate assay to evaluate differences between recipients who were treated with cyclosporine-or tacrolimus-based immunosuppressive therapy. Materials and Methods: Adenosine triphosphate levels were measured in peripheral CD4+ cells before and after transplant and were correlated with clinical outcomes in 45 kidney transplant recipients. These recipients received immunosuppressive therapy with either cyclosporine (23 patients) or tacrolimus (22 patients). Results: Adenosine triphosphate levels were significantly lower in the cyclosporine-than tacrolimus-based therapy groups from 2 to 6 weeks after transplant. Adenosine triphosphate levels were similar between these groups before and 1 week after transplant. The frequency of cytomegalovirus infection was greater in the recipients who received cyclosporine (17 patients [74%]) than tacrolimus (6 patients [27%]; P ≤ .003). The frequency of acute rejection episodes was similar between the cyclosporine and tacrolimus groups. Conclusions:These observations suggest that cyclosporine-based immunosuppressive therapy causes excessive immunosuppression compared with tacrolimus-based therapy, evidenced by the lymphocyte adenosine triphosphate levels. The adenosine triphosphate assay using peripheral CD4+ cells may be a useful method for predicting the occurrence of cytomegalovirus infections in kidney transplant recipients.

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“…One available assay is the Immuknow Cylex assay, which detects cell-mediated immunity by measuring the concentration of ATP from stimulated CD4 cells. Although the test may have a role in identifying overimmunosuppressed individuals at risk for infection and even death (30), its utility in predicting who is at risk for rejection has not been consistently evident (31), and not all insurance companies cover the test. Another test that some groups have examined to assess cellular alloreactivity is the enzyme-linked immunosorbent spot (ELISPOT) assay.…”

Section: Monitoringmentioning

confidence: 99%

Monitoring and Managing Graft Health in the Kidney Transplant Recipient

Josephson

2011

Clinical Journal of the American Society of Nephrology

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SummaryOngoing monitoring of kidney transplants is a widely accepted and practiced part of posttransplantation management. One reason to monitor is to evaluate whether the transplant is stable. The transplant community evaluates stability by checking kidney function. Despite problems with sensitivity and specificity, obtaining serial serum creatinine levels is the most common approach to assessing kidney function. Some programs supplement serial serum creatinine levels with surveillance kidney biopsies. Although not uniformly accepted as beneficial, surveillance biopsies are useful in select subsets of patients such as highly sensitized recipients. Recent biopsy studies shed light on which histopathology findings portend poor prognoses. The Long-Term Deterioration of Kidney Allograft Function Study (DeKAF) and similar studies that will prospectively evaluate therapeutic interventions should help the transplant community better define how to monitor and manage the kidney transplant optimally. In the meantime, Kidney Diseases: Improving Global Outcomes (KDIGO) provides an evidence-based approach toward monitoring and managing the kidney transplant.

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Significance of immune cell function monitoring in renal transplantation after Thymoglobulin induction therapy

Cited by 54 publications

References 40 publications

An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma

An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma

Untitled

Monitoring and Managing Graft Health in the Kidney Transplant Recipient

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