Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (31): 5785-5788.doi: 10.3969/j.issn.1673-8225.2011.31.020

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Pre-transplant frequency of donor-specific, interferon-gamma-producing T lymphocytes as a tool for forecasting acute rejections following kidney transplantation

Chen Wei-guo, Wang Qing-tang, Wang Liang, Yang Hang, Zhou Peng, Cao Wen-feng, Liu Xiang-dan, Li Sha-dan   

  1. Department of Urology Surgery, General Hospital of Chengdu Military Area Command of Chinese PLA, Chengdu  610038, Sichuan Province, China
  • Received:2011-01-04 Revised:2011-03-20 Online:2011-07-30 Published:2011-07-30
  • About author:Chen Wei-guo★, Master, Associate chief physician, Department of Urology Surgery, General Hospital of Chengdu Military Area Command of Chinese PLA, Chengdu 610038, Sichuan Province, China chenweiguo2004@sina.com

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Abstract:

BACKGROUND: Increasing the accuracy of rejection risk forecast post-transplant can provide reference for individualized use of immunosuppressive agent post-transplant.
OBJECTIVE: To investigate an immunological assay for donor-specific alloreactivity to identify patients at risk for future acute rejection.
METHODS: The pre-transplant frequency of donor-specific, interferon-γ-producing T lymphocytes in 115 patients who received kidney allograft was tested prospectively by ELISPOT-assay. Acute rejection and pneumonitis were observed within the period of follow-up. The relationship between HLA mismatching and acute rejection was also observed. 
RESULTS AND CONCLUSION: 25 patients who experienced acute rejection had significantly higher frequency of primed donor-specific T cells prior to transplantation compared with 90 patients without acute rejection (78.75±32.81 vs. 14.85±14.66,  P < 0.01). The sensitivity and specificity of the test were 84.0% and 94.4%. No significant difference was observed in HLA mismatches between patients who experienced acute rejection and patients who were free from acute rejection (P > 0.05). The rate of pneumonitis was higher in patients who experienced acute rejection than those who did not experience (44.0% vs. 14.4%, P < 0.05). The pre-transplant frequency of donor-specific memory cells correlated with the post-transplant risk of developing acute rejection episodes, may allow improved pairing of recipients with donors, and could identify high risk recipients for prophylactic, aggressive immunosuppression.

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