title: Immune cell function assay in pediatric heart transplant recipients.
abstract: The ImmuKnow ICFA reports ex vivo CD4 lymphocyte activation to quantify immunosuppression. Limited organ and age-specific data exist for pediatric heart transplant recipients. We sought to examine their normative values and ICFA's association with rejection/infection. A total of 380 ICFAs from 58 heart transplant recipients (6.5/recipient) were studied retrospectively. The median age at the time of their first ICFA was 5.3 yr (IQR 2.4-12.1 yr). ICFA levels during immunologic stability (n = 311) were a median of 305 (IQR: 172-483) and mean of 353 (s.d. ± 224) ng ATP/mL. ICFA levels trended lower with advancing age. ICFA levels during immunologic stability increased over time from transplant after the first six months but were not correlated with calcineurin inhibitor levels or the type used. There is no association between ICFA values during stability and rejection (median 368 ATP ng/mL; IQR 153-527) or infection (median 293 ATP ng/mL; IQR 198-432). In contrast to the manufacturer's suggested ranges, the immunologic stable ranges in pediatric cardiac recipients were very different. ICFA values during immunologic stability are related to time from transplant in pediatric heart recipients. ICFA's ability to discriminate rejection or infection from immunologic stability was not demonstrated.
authors.affiliation: Department of Surgery, Gold Coast Hospital, Southport, Qld, Australia.
authors.forename: Man-Shun
authors.initials: MS
authors.lastname: Wong
authors.forename: Robert
authors.initials: R
authors.lastname: Boucek
authors.forename: Mariska
authors.initials: M
authors.lastname: Kemna
authors.forename: Joe
authors.initials: J
authors.lastname: Rutledge
authors.forename: Yuk
authors.initials: Y
authors.lastname: Law
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000293:Adolescent; D000367:Age Factors; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006330:Heart Defects, Congenital / Q000097:blood / Q000276:immunology / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000276:immunology; D008213:Lymphocyte Activation; D008297:Male; D010372:Pediatrics; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D066027:Transplant Recipients; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D000255:Adenosine Triphosphate
keywords: heart transplant; immune function; immunosuppression; infection; lymphocyte activation; rejection