Liver transplantationCandidatePeritransplant Monitoring of Immune Cell Function in Adult Living Donor Liver Transplantation
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Patients and Methods
Between July 2008 and January 2009, 128 adult patients undergoing primary LDLT at our institution were prospectively enrolled. Blood samples were taken 1 day before OLT, twice during the first week after OLT, and once a week thereafter until discharge from the hospital. Patients readmitted for graft dysfunction were also included in our survey. Immune cell function was assayed by the ImmuKnow assay (Cylex Inc, Columbia, Md, USA). However, patients assayed by ImmuKnow fewer than three times
Immune Cell Function in Healthy Individuals
The 200 living donor candidates consisted of 133 men (66.5%) and 67 women (33.5%), of mean age 32.6 ± 9.1 years (range, 20–57 years). The mean proportion of T-helper/inducer cells was 36.8% ± 8.2% (range: 16.3%–59.9%). In response to ImmuKnow, 24 (12%) individuals showed a strong immune response, 154 (77%) a moderate response, and 22 (11%) a low response (Fig 1). There was no significant correlation between age and ImmuKnow level (r2 < .001, P = .08). However, men tended to show a stronger
Discussion
Monitoring of functional immunity in OLT recipients may help in appropriate management of such patients, avoiding acute rejection and the side effects of drugs and infections, especially during the early posttransplant period. As most serious complications following LDLT occur within the first few months, strict patient surveillance, including monitoring of rejection and infection, should be maintained for this period. The ImmuKnow assay is specifically designed to assess the overall immune
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Cited by (12)
Predictive Value of Immune Cell Functional Assay for Non-Cytomegalovirus Infection in Lung Transplant Recipients: A Multicenter Prospective Observational Study
2021, Archivos de BronconeumologiaCitation Excerpt :Randomized clinical trials in which immunosuppressive therapy is adjusted according to ImmuKnow® or other immunological monitoring assays are needed. Studies on acute rejection performed in liver transplantation4,16–18 have shown high specificity (94–100%) and low sensitivity (9–50%) for ImmuKnow® with a cut-off point of ATP > 525 ng/mL. The results are poorer in kidney transplantation, with a specificity of 65–80% and a sensitivity of 33–23%.
Correlation Between Immunosuppressive Therapy and CD4<sup>+</sup> T-Cell Intracellular Adenosine Triphosphate Levels in Liver Transplant Recipients
2016, Transplantation ProceedingsCitation Excerpt :Reed et al [17] confirmed that, after erythrocytes of transplanted patients were added to cell proliferation experiments, the erythrocytes retained their immunosuppressive effects. They also found that FK506 concentration in whole blood had no clear correlation with CD4+ T-cell iATP levels as detected by the Cylex Immuknow Assay [10]. Lymphocyte has its own regulatory mechanism, and different immunosuppressive drugs do not affect immune cell function in the same way.
Increased intracellular adenosine triphosphate level as an index to predict acute rejection in kidney transplant recipients
2014, Transplant ImmunologyCitation Excerpt :We demonstrated that the trend of intracellular ATP increasing rather than a value at a single time point was more helpful to identify patients at higher risk of rejection. Several previous studies have shown that the high intracellular ATP level (≥ 525 ng/ml) at a single time point lacked both sensitivity and specificity for prediction of AR episodes [10,11,16]. In our large population study and the long-term serial testing scheme, we observed that patients with low intracellular ATP level (< 525 ng/ml) still had strong cellular immune responses and experienced AR episodes.
Assessing immunologic function through CD4 T-lymphocyte ahenosine triphosphate levels by ImmuKnow assay in Chinese patients following renal transplantation
2011, Transplantation ProceedingsCitation Excerpt :ATP levels from the ImmunKnow assay have not been shown to be predictive of an acute rejection episode or of a significant infection among pediatric heart transplant patients.27 Peritransplant assessments of immune responses with the assay do not reliably predict the occurrence of acute rejection episodes.28 Serban asserted that the ImmuKnow assay results need to be interpreted with caution in renal transplant patients receiving thymoglobulin induction therapy; although low ATP levels identified patients at increased risk for infection, high ATP values did not correlate with rejection, which did not justify increased immunosuppression.29
S. Hwang and K.H. Kim equally contributed as co-first authors for this study.
This study was supported by the investigator research fund from the Korean Society for Transplantation and Asan Institute for Life Science.