Measurement of CD4+ T-cell function in predicting allograft rejection and recurrent hepatitis C after liver transplantation.
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.
Hashimoto
Koji
K
Departments of Hepato-Pancreato-Biliary and Transplant Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Miller
Charles
C
Hirose
Kenzo
K
Diago
Teresa
T
Aucejo
Federico
F
Quintini
Cristiano
C
Eghtesad
Bijan
B
Corey
Rebecca
R
Yerian
Lisa
L
Lopez
Rocio
R
Zein
Nizar
N
Fung
John
J
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
D007166:Immunosuppressive Agents; D000255:Adenosine Triphosphate