Measurement of CD4+ T-cell function in predicting allograft rejection and recurrent hepatitis C after liver transplantation

Koji Hashimoto, Charles Miller, Kenzo Hirose, Teresa Diago, Federico Aucejo, Cristiano Quintini, Bijan Eghtesad, Rebecca Corey, Lisa Yerian, Rocio Lopez, Nizar Zein, John Fung

Research output: Contribution to journalArticlepeer-review

Abstract

Recurrence of hepatitis C virus (HCV) can be difficult to distinguish from acute cellular rejection (ACR) following liver transplantation. The Cylex Immune Function Assay (ImmuKnow) provides objective measure of recipient's immune function. The goal is to assess the ability of this assay to distinguish these similar conditions. A retrospective review was performed in 54 recipients with HCV. ImmuKnow assays were measured with allograft biopsies. Levels of adenosine triphosphate (ATP) release from CD4+ T cells (ng/mL) were compared with the following biopsy result classifications: 365 ± 130 with ACR (n = 11), 152 ± 100 with recurrent HCV (n = 26), 240 ± 71 with normal biopsies (n = 12), and 157 ± 130 with overlapping features of ACR and recurrent HCV (n = 5). Recipients with recurrent HCV had lower immune response than those with ACR (p < 0.0001).Using a cutoff level of 220, the sensitivity and specificity for distinguishing two conditions were 88.5% and 90.9%, respectively. When recipients with overlapping features had low immune response, three of four recipients' subsequent biopsies showed recurrent HCV. In conclusion, the ImmuKnow assay can be a sensitive and specific additional test for distinguishing recurrent HCV from ACR and may be useful for predicting which recipients may be most vulnerable to recurrent HCV.

Original languageEnglish (US)
Pages (from-to)701-708
Number of pages8
JournalClinical Transplantation
Volume24
Issue number5
DOIs
StatePublished - Sep 1 2010

Keywords

  • Acute cellular rejection
  • CD4+ T cell
  • Cylex ImmuKnow assay
  • Liver transplantation
  • Recurrent hepatitis C

ASJC Scopus subject areas

  • Transplantation

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