A practical approach to immune monitoring in kidney transplantation.
In the last years, there has been a growing interest in the development of new assays available to monitor kidney transplantation. These assays will permit strategies for the minimization of immunosuppression, for induction of operational tolerance, for an early and noninvasive diagnosis of acute rejection, for prevention of adverse effects of immunosuppressive drugs and for measurement of the net immunosuppressive state. Today, there is not one test that helps us monitor the outcome of kidney recipients safely. The best strategy will be the sequential utilization of a combination of several of these tests. Further studies and further developed assays are needed to obtain an adequate immune monitoring strategy in kidney transplantation. Nowadays, pretransplant and post-transplant IFN-gamma ELISPOT assay, donor-specific antibody determination, sCD30 test and Cylex(R) ImmuKnowTM assay provide valuable information about immune status that can help us guide transplant therapy in vivo. Transvivo DTH assay, tetramer staining, quantification of cell proliferation by CFSE labelling, human leukocyte antigen-G determination, phenotyping of recipient immune cells, detection of tolerogeneic dendritic cell precursors, T-cell receptor landscaping and quantification of gene and protein expression need more studies to know their exact role as monitoring markers in kidney transplant patients.
Rodrigo
E
E
Service of Nephrology, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain. nefrce@humv.es
Arias
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M
D003713:Dendritic Cells; D015870:Gene Expression; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D015166:Monitoring, Immunologic; D010641:Phenotype; D013601:T-Lymphocytes