Conflict of interest: None.
Use of immune function test in monitoring immunosuppression in liver transplant recipients
Article first published online: 3 MAY 2012
© 2012 John Wiley & Sons A/S.
Volume 26, Issue 6, pages 826–832, November/December 2012
How to Cite
Te HS, Dasgupta KA, Cao D, Satoskar R, Mohanty SR, Reau N, Millis JM, Jensen DM. Use of immune function test in monitoring immunosuppression in liver transplant recipients.
- Issue published online: 6 DEC 2012
- Article first published online: 3 MAY 2012
- Manuscript Accepted: 22 NOV 2011
- immune function test;
- liver transplantation
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.