Cell mediated immunity (CMI) and post transplant viral infections--role of a functional immune assay to titrate immunosuppression.
Cell mediated immunity (CMI) was assessed by the ImmuKnow assay in 12 patients after kidney transplantation, who presented with viral infection. Treatment included lowering of immunosuppression in all cases and antiviral treatment if indicated. The assay was repeated during the follow up. The ImmuKnow assay at time of presentation of viral infections was 56.8+/-58.2 (range 3-178; median 22) ATP ng/ml. With the clearance of viral infection and lowering of immunosuppression, the assay showed an increase in the level of CMI at 194.5+/-118.9 (range 53-409; median 150) ATP ng/ml. There was viral clearance or stabilization in all cases and there was no incidence of allograft rejection. The ImmuKnow assay of CMI can be used to titrate initial immunosuppression reduction and its subsequent increase, in patients with viral infection after transplantation.
Gautam
A
A
Division of Organ Transplantation, Rhode Island Hospital, Providence, Rhode Island 02903, USA. agautam@lifespan.org <agautam@lifespan.org>
Fischer
S A
SA
Yango
A F
AF
Gohh
R Y
RY
Morrissey
P E
PE
Monaco
A P
AP
D000255:Adenosine Triphosphate / Q000032:analysis / Q000378:metabolism; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000378:metabolism; D002648:Child; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects / Q000276:immunology*; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D008875:Middle Aged; D015166:Monitoring, Immunologic / Q000379:methods; D010835:Phytohemagglutinins / Q000494:pharmacology; D016896:Treatment Outcome; D019562:Viral Load; D014777:Virus Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology*
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D010835:Phytohemagglutinins; D000255:Adenosine Triphosphate