Decreased effect of immunosuppression on immunocompetence in African - Americans after kidney and liver transplantation

Naoki Nagashima, Takuji Watanabe, Michio Nakamura, Ahmed Shalabi, James F. Burdick

Research output: Contribution to journalArticlepeer-review

Abstract

Several studies indicate that the poorer outcomes for African-Americans after transplantation may be due to decreased effectiveness of immunosuppressive agents. Using an in vitro test of immunocompetence (IMC), we measured the effects of immunosuppression on African-American, compared with Caucasian, kidney or liver transplantation recipients. The IMC result was the highest of three mixed lymphocyte culture responses using validated stimulator cell pools. A total of 293 tests were done in Caucasians and 144 in African-Americans. Overall, the IMC for African-Americans was 38, compared with 19 for Caucasians (p <0.01). This decreased effect of immunosuppression (higher IMC) was the same for liver as for kidney transplant recipients, occurred at the 2-3-yr interval, and was largely in patients of tacrolimus (FK506), with a strong but not significant trend in cyclosporine (CYA) recipients. The two groups were on the same nominal immunosuppression and FK506 and CYA levels were not different. We conclude that African-Americans retain more immune responsiveness on equivalent dose immunosuppression, notable particularly in years 2-3 after transplantation when earlier graft loss occurs in this group.

Original languageEnglish (US)
Pages (from-to)111-115
Number of pages5
JournalClinical Transplantation
Volume15
Issue number2
DOIs
StatePublished - 2001

Keywords

  • African-American
  • Cyclosporine
  • Immunocompetence
  • Immunosuppression
  • Kidney transplantation
  • Liver transplantation
  • Lymphocyte activation
  • Mycophenolate mofetil
  • Tacrolimus

ASJC Scopus subject areas

  • Transplantation

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