Posttransplant peripheral blood donor-specific interferon-γ enzyme-linked immune spot assay differentiates risk of subclinical rejection and de novo donor-specific alloantibodies in kidney transplant recipients.
Posttransplant peripheral blood donor-specific interferon-γ enzyme-linked immune spot assay differentiates risk of subclinical rejection and de novo donor-specific alloantibodies in kidney transplant recipients.
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DOI：
10.1016/j.kint.2016.12.024
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发表时间：
2017-07
影响因子：
19.6
通讯作者：
Bestard O
中科院分区：
文献类型：
--
作者：
Crespo E;Cravedi P;Martorell J;Luque S;Melilli E;Cruzado JM;Jarque M;Meneghini M;Manonelles A;Donadei C;Lloberas N;Gomà M;Grinyó JM;Heeger P;Bestard O
Noninvasive diagnosis of kidney allograft inflammation in transplant recipients with stable graft function (subclinical rejection) could permit more effective therapy and prevent later development of de novo anti-donor HLA antibodies and/or graft dysfunction. Here we tested whether quantifying post-transplant donor-specific alloreactive T cells by IFN-γ ELISPOT assay noninvasively detects subclinical T-cell mediated rejection and/or predicts development of anti-donor HLA antibodies. Using an initial cross-sectional cohort of 60 kidney transplant patients with six-month surveillance biopsies, we found that negative ELISPOT assays accurately ruled out the presence of subclinical T cell mediated rejection. These results were validated using a distinct prospective cohort of 101 patients where donor specific IFN-γ ELISPOT results at both three- and six-months post-transplant significantly differentiated patients with subclinical T cell mediated rejection at six-month, independent of other clinical variables (odds ratio 0.072, 95% confidence interval 0.008-0.653). The post-transplant donor-specific IFN-γ ELISPOT results independently associated with subsequent development of significant anti-donor HLA antibodies (0.085, 0.008-0.862) and with significantly worse two-year function (estimated glomerular filtration rate) compared to patients with a negative test. Thus, post-transplant immune monitoring by donor-specific IFN-γ ELISPOT can assess risk for developing subclinical T cell mediated rejection and anti-donor HLA antibodies, potentially limiting the need for surveillance biopsies. Our study provides a guide for individualizing immunosuppression to improve post-transplant outcomes.
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DOI：
10.1111/ajt.12286
发表时间：
2013-07
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
--
作者：
Ashoor I;Najafian N;Korin Y;Reed EF;Mohanakumar T;Ikle D;Heeger PS;Lin M
通讯作者：
Lin M
影响因子：
6.2
作者：
Chemouny, Jonathan-Maurice;Suberbielle, Caroline;Anglicheau, Dany
通讯作者：
Anglicheau, Dany
影响因子：
8.8
作者：
Cosio, FG;Grande, JP;Stegall, MD
通讯作者：
Stegall, MD
影响因子：
6.2
作者：
Moreso, Francesc;Carrera, Marta;Seron, Daniel
通讯作者：
Seron, Daniel
影响因子：
13.6
作者：
Bestard, Oriol;Nickel, Peter;Reinke, Petra
通讯作者：
Reinke, Petra