title: Association of immune cell function assay with protocol biopsy findings and viral infections in well matched kidney transplant recipients.
abstract: BACKGROUND
  Cylex Immune Cell Function Assay (ICFA) is in clinical use, but little is known about its association with screening of viral infections or findings in protocol biopsies.
  
  
  METHODS
  We analyzed ICFA in our well-matched kidney transplant population. Helsinki University Hospital patients who received a kidney transplant after July 2007 were analyzed. Patients with at least 6 months follow-up and ICFA measured together with the screening for cytomegalovirus (CMV), or polyomaviruses from urine or plasma, or patients with a protocol biopsy at 6 or 12 months taken at the time of the ICFA were included (n = 27). Immunosuppression was usually implemented with mycophenolate mofetil (MMF), steroids and cyclosporine A (CyA). Biopsies were analyzed with chronic allograft damage index (CADI).
  
  
  RESULTS
  Mean immune response in 61 samples was 368 +/- 179 ATP ng/ml. Immune response was lower during BK virus (BKV) or CMV viremia compared to no viremia (p = 0.009 and p = 0.017), and no viremia was seen if immune response was > 380. BK or JC viruria was not associated with low immune response. Immune responses did not differ between patients with high or low CADI scores or between patients with immune activation or no immune activation in biopsies. Immune response in our population was higher than previously reported without increased risk of rejections. ICFA correlated with viremia but not with findings in protocol biopsies.
  
  
  CONCLUSIONS
  The optimal immune response in our population needs further studies.
authors.affiliation: Department of Medicine, Division of Nephrology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland. ikkahelantera@helsinki.fr
authors.forename: I
authors.initials: I
authors.lastname: Helanterä
authors.forename: P
authors.initials: P
authors.lastname: Koskinen
mesh_terms: D001739:BK Virus / Q000276:immunology; D001706:Biopsy; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006085:Graft Survival; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007577:JC Virus / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D018709:Statistics, Nonparametric; D014184:Transplantation, Homologous; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D014766:Viremia / Q000175:diagnosis* / Q000821:virology
chemical_list: D007166:Immunosuppressive Agents