Pre-transplant IFN-γ ELISPOTs are associated with post-transplant renal function in african american renal transplant recipients
Pre-transplant IFN-γ ELISPOTs are associated with post-transplant renal function in african american renal transplant recipients
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DOI：
10.1111/j.1600-6143.2005.00958.x
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发表时间：
2005-08-01
影响因子：
8.8
通讯作者：
Hricik, DE
中科院分区：
文献类型：
--
作者：
Augustine, JJ;Siu, DS;Hricik, DE
最终交叉配血试验通常用于评估移植后抗体介导的移植物损伤/排斥反应的风险。类似地，我们假设移植前抗供体效应/记忆T细胞的定量测量将独立评估移植后风险。为了解决这个假设，我们确定了移植前的频率，供者特异性干扰素-γ（IFN-γ）酶联免疫吸附斑点ELISPOT试验阳性的受试者中，37例接受他克莫司和西罗莫司免疫抑制治疗的非裔美国人死亡供体肾移植患者的结果与移植后结局相关。在37例患者中的14例（38%）中检测到（> 25个斑点/300 000个细胞）。ELISPOT阳性患者中活检证实的急性排斥反应发生率为50%（7/14），ELISPOT阴性患者中为17%（4/23）（p = 0.036）。ELISPOT阳性患者12个月时计算的肾小球滤过率（MDRD）为37 ± 16 mL/min，ELISPOT阴性患者为55 ± 20 mL/min（p = 0.01）。通过线性回归分析（p = 0.001），ELISPOT状态在12个月时仍然与同种异体移植物功能相关，与排斥反应和其他影响变量无关。在接受他克莫司和西罗莫司为基础的免疫抑制的非裔美国人中，移植前供者定向IFN-γ ELISPOT抗供者细胞免疫评估可作为“细胞交叉配型”，并与肾移植功能独立相关。
Final crossmatch testing is routinely used to assess the risk of antibody-mediated graft injury/rejection post-transplant. Analogously, we postulated that quantitative measurements of anti-donor effector/memory T cells pre-transplant would independently assess post-transplant risk. To address this hypothesis, we determined the frequencies of pre-transplant, donor-specific interferon-gamma (IFN-gamma) enzyme-linked immunosorbent spots (ELISPOTs) and correlated the results with post-transplant outcomes in 37 African American recipients of deceased donor kidney transplants treated with tacrolimus- and sirolimus-based immunosuppression.A positive ELISPOT test (> 25 spots/300 000 cells) was detected in 14 (38%) of 37 patients. The incidence of biopsy-proven acute rejection was 50% (7/14) in ELISPOT-positive versus 17% (4/23) in ELISPOT-negative patients (p = 0.036). Calculated glomerular filtration rate (MDRD) at 12 months was 37 +/- 16 mL/min in ELISPOT-positive versus 55 +/- 20 mL/min in ELISPOT-negative patients (p = 0.01). ELISPOT status remained a correlate of allograft function at 12 months by linear regression analysis (p = 0.001), independent of rejection and other contributing variables. Pre-transplant donor-directed IFN-gamma ELISPOT assessment of anti-donor cellular immunity may function as a 'cellular crossmatch' and independently correlates with renal allograft function in African Americans receiving tacrolimus- and sirolimus-based immunosuppression.