title: Use of immune function test in monitoring immunosuppression in liver transplant recipients.
abstract: Immune function test (Immuknow™) is a measure of cell-mediated immunity based on peripheral CD4+ T cell adenosine triphosphate activity (desired range, 225-525 ng/mL). We evaluated the role of immune function test (IFT) in monitoring and adjustment of immunosuppression in orthotopic liver transplant (OLT) recipients. A total of 289 IFTs were obtained from 171 patients from March 2007 to June 2008. Graft/patient status was classified as stable, serious infection, or malignancy. IFT levels were analyzed with duration of follow-up after OLT, graft/patient status, and the presence of hepatitis C (HCV) infection. The mean age was 54±14 yr, with 62% men. The median follow-up was 65 (2-249) months. Mean IFT levels were significantly lower in patients who were <24 months than in those≥24 months post-OLT (220±19.5 vs. 257±11.3 ng/mL, p=0.03). Clinically stable patients had higher IFT levels than those with serious infection or malignancy (254±11.1 vs. 162.5±23.9, p<0.001). HCV-infected patients had lower IFT levels than uninfected patients (206.7±15.7 vs. 273±12.0 ng/mL, p<0.001). Immunosuppression was reduced in 58 patients with IFT levels<225 ng/mL, and 90% maintained stable graft function after a median follow-up of 22 (1-39) months. IFT may be a useful tool in monitoring and lowering of immunosuppression in long-term OLT recipients.
authors.affiliation: Center for Liver Diseases, University of Chicago Medical Center, Chicago, IL 60637, USA. hte@medicine.bsd.uchicago.edu
authors.forename: Helen S
authors.initials: HS
authors.lastname: Te
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Dasgupta
authors.forename: Dingcai
authors.initials: D
authors.lastname: Cao
authors.forename: Rohit
authors.initials: R
authors.lastname: Satoskar
authors.forename: Smruti R
authors.initials: SR
authors.lastname: Mohanty
authors.forename: Nancy
authors.initials: N
authors.lastname: Reau
authors.forename: James Michael
authors.initials: JM
authors.lastname: Millis
authors.forename: Donald M
authors.initials: DM
authors.lastname: Jensen
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000276:immunology* / Q000821:virology; D006801:Humans; D007111:Immunity, Cellular; D007118:Immunoassay; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000150:complications; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents