The relationship between adenosine triphosphate within CD4<sup>+</sup> T lymphocytes and acute rejection after liver transplantation

Dong, Jia-yong; Yin, Hao; Li, Ruidong; Ding, Guoyu; Fu, Zhi-ren; Wu, Youmin; Wang, Zhengxin

doi:10.1111/j.1399-0012.2011.01429.x

Cited by 15 publications

(11 citation statements)

References 16 publications

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“…High values are associated with the risk of rejection in kidney , heart , liver , and pancreas transplant patients, although other studies have shown no significant associations . Kowalski et al.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of the immune function assay in pediatric living donor liver transplantation

Fukuda

Imadome

Sakamoto

et al. 2014

Pediatric Transplantation

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The immune function (ImmuKnow) assay is a measure of cell-mediated immunity based on the peripheral CD4+ T cell ATP activity. The efficacy of ImmuKnow in pediatric LDLT is not well documented. The aim of this study was to assess the correlations between the ImmuKnow and the clinical status in pediatric LDLT recipients. A total of 716 blood samples were obtained from 60 pediatric LDLT recipients (one month to 16 yr of age). The recipient's status was classified as follows: stable, infection, or rejection. The ImmuKnow values in the pediatric LDLT recipients with a clinically stable status had a lower immune response (IQR 85-297 ATP ng/mL) than that previously reported in adults. Meanwhile, the ImmuKnow values of the stable patients were not correlated with age. Furthermore, a significant difference was found in the ImmuKnow values between the bacterial or fungal infection and stable groups, but not between the CMV or EBV infection and stable groups. The ImmuKnow levels in the pediatric LDLT were lower than those observed in the adult LDLT. The proposed reference value is between 85 and 297 ATP ng/mL in pediatric LDLT recipients. We conclude that the ImmuKnow assay could be helpful for monitoring pediatric LDLT recipients with bacterial or fungal infections.

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Section: Discussionmentioning

confidence: 98%

Evaluation of the immune function assay in pediatric living donor liver transplantation

Fukuda

Imadome

Sakamoto

et al. 2014

Pediatric Transplantation

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“…On the other hand, a recipient with a response value of 700 ng/mL was 30 times more likely to develop rejection than a recipient with a lower immune response value 15. Despite this, several more studies of liver transplant patients have reported inconclusive results for the performance of the ImmuKnow test in predicting acute rejection and infection, and this has precluded the generalization of its use 16‐25. Thus, we performed a systemic review and meta‐analysis to investigate the diagnostic accuracy of the ImmuKnow test for the risk of infection and acute rejection in liver transplant recipients.…”

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confidence: 99%

ImmuKnow as a diagnostic tool for predicting infection and acute rejection in adult liver transplant recipients: A systematic review and meta-analysis

et al. 2012

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Immune status monitoring of transplant recipients could identify patients at risk of acute rejection, infection, and cancer, which are important sources of morbidity and mortality in these patients. The ImmuKnow assay provides an objective assessment of the cellular immune function of immunosuppressed patients. Inconclusive results concerning the ability of the ImmuKnow test to predict acute rejection and infection have raised concerns about the predictive value of ImmuKnow in liver transplant recipients. We conducted a systematic literature review to identify studies published up to March 2012 that documented the use of ImmuKnow for monitoring immune function in liver transplant recipients. The study quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 score. We identified 5 studies analyzing ImmuKnow performance for infection and 5 studies analyzing ImmuKnow performance for acute rejection. The pooled sensitivity, specificity, positive likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve were 83.8% [95% confidence interval (CI) ¼ 78.5%-88.3%], 75.3% (95% CI ¼ 70.9%-79.4%), 3.3 (95% CI ¼ 2.8-4.0), 14.6 (95% CI ¼ 9.6-22.3), and 0.824 6 0.034, respectively, for infection and 65.6% (95% CI ¼ 55.0%-75.1%), 80.4% (95% CI ¼ 76.4%-83.9%), 3.4 (95% CI ¼ 2.4-4.7), 8.8 (95% CI ¼ 3.1-24.8), and 0.835 6 0.060, respectively, for acute rejection. Heterogeneity was low for infection studies and high for acute rejection studies. In conclusion, the ImmuKnow test is a valid tool for determining the risk of further infection in adult liver transplant recipients. Significant heterogeneity across studies precludes the conclusion that ImmuKnow identifies liver transplant patients at risk for rejection. Liver Transpl 18:1245-1253, 2012. V C 2012 AASLD.Received April 18, 2012; accepted June 16, 2012.In the field of solid organ transplantation, the maintenance of an adequate level of immunosuppression is of the greatest importance. On the one hand, overimmunosuppression can promote the appearance of infection, cancer, and other undesirable secondary effects. Infectious diseases remain an important source of morbidity and mortality for all types of transplant patients. 1 Up to two-thirds of all liver Abbreviations: AUC, area under the curve; AUC-ROC, area under the receiver operating characteristic curve; CI, confidence interval; df, degrees of freedom; DOR, diagnostic odds ratio; HCV, hepatitis C virus; iATP, intracellular adenosine triphosphate; QUADAS-2, Quality Assessment of Diagnostic Accuracy Studies 2; SE, standard error; SROC, summary receiver operating characteristic.

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“…Major surgery is associated with a sustained postoperative reduction in the numbers and activity of NK cells and T lymphocyte subsets, including lymphokine-activated killer T cells [4,16,17]. This can significantly delay postoperative immune function; one study showed that T lymphocyte activation in response to mitogens may be delayed up to 1 week after surgery in patients underwent liver transplantation [18]. For cancer patients, this postoperative immune suppression may increase the risk of tumor recurrence, progression and metastasis [19,20].…”

Section: Discussionmentioning

confidence: 96%

Comparison of postoperative immune function in patients with thoracic esophageal cancer after video-assisted thoracoscopic surgery or conventional open esophagectomy

Tan

Zhong

Yang

et al. 2016

International Journal of Surgery

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The relationship between adenosine triphosphate within CD4⁺ T lymphocytes and acute rejection after liver transplantation

Cited by 15 publications

References 16 publications

Evaluation of the immune function assay in pediatric living donor liver transplantation

Evaluation of the immune function assay in pediatric living donor liver transplantation

ImmuKnow as a diagnostic tool for predicting infection and acute rejection in adult liver transplant recipients: A systematic review and meta-analysis

Comparison of postoperative immune function in patients with thoracic esophageal cancer after video-assisted thoracoscopic surgery or conventional open esophagectomy

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The relationship between adenosine triphosphate within CD4+ T lymphocytes and acute rejection after liver transplantation

Cited by 15 publications

References 16 publications

Evaluation of the immune function assay in pediatric living donor liver transplantation

Evaluation of the immune function assay in pediatric living donor liver transplantation

ImmuKnow as a diagnostic tool for predicting infection and acute rejection in adult liver transplant recipients: A systematic review and meta-analysis

Comparison of postoperative immune function in patients with thoracic esophageal cancer after video-assisted thoracoscopic surgery or conventional open esophagectomy

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The relationship between adenosine triphosphate within CD4⁺ T lymphocytes and acute rejection after liver transplantation