title: Measurement of CD4+ T-cell function in predicting allograft rejection and recurrent hepatitis C after liver transplantation.
abstract: Recurrence of hepatitis C virus (HCV) can be difficult to distinguish from acute cellular rejection (ACR) following liver transplantation. The Cylex Immune Function Assay (ImmuKnow) provides objective measure of recipient's immune function. The goal is to assess the ability of this assay to distinguish these similar conditions. A retrospective review was performed in 54 recipients with HCV. ImmuKnow assays were measured with allograft biopsies. Levels of adenosine triphosphate (ATP) release from CD4+ T cells (ng/mL) were compared with the following biopsy result classifications: 365 ± 130 with ACR (n = 11), 152 ± 100 with recurrent HCV (n = 26), 240 ± 71 with normal biopsies (n = 12), and 157 ± 130 with overlapping features of ACR and recurrent HCV (n = 5). Recipients with recurrent HCV had lower immune response than those with ACR (p < 0.0001).Using a cutoff level of 220, the sensitivity and specificity for distinguishing two conditions were 88.5% and 90.9%, respectively. When recipients with overlapping features had low immune response, three of four recipients' subsequent biopsies showed recurrent HCV. In conclusion, the ImmuKnow assay can be a sensitive and specific additional test for distinguishing recurrent HCV from ACR and may be useful for predicting which recipients may be most vulnerable to recurrent HCV.
authors.affiliation: Departments of Hepato-Pancreato-Biliary and Transplant Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Koji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Charles
authors.initials: C
authors.lastname: Miller
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hirose
authors.forename: Teresa
authors.initials: T
authors.lastname: Diago
authors.forename: Federico
authors.initials: F
authors.lastname: Aucejo
authors.forename: Cristiano
authors.initials: C
authors.lastname: Quintini
authors.forename: Bijan
authors.initials: B
authors.lastname: Eghtesad
authors.forename: Rebecca
authors.initials: R
authors.lastname: Corey
authors.forename: Lisa
authors.initials: L
authors.lastname: Yerian
authors.forename: Rocio
authors.initials: R
authors.lastname: Lopez
authors.forename: Nizar
authors.initials: N
authors.lastname: Zein
authors.forename: John
authors.initials: J
authors.lastname: Fung
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000502:physiology*; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology* / Q000821:virology; D006801:Humans; D007111:Immunity, Cellular; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D000255:Adenosine Triphosphate