Performance of the ImmuKnow Assay in Differentiating Infection and Acute Rejection After Kidney Transplantation: A Meta-Analysis

Wang, Z.; Liu, X.; Lu, Pei-Hua; Han, Ze‐Guang; Tao, Jun; Wang, J.; Liu, K.; Wu, Buyun; Yin, Chengqiang; Tan, Ruoyun; Gu, Min

doi:10.1016/j.transproceed.2014.09.109

Cited by 19 publications

(14 citation statements)

References 38 publications

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“…The pendulum continues to swing between over and underimmunosuppression and as researchers and clinicians attempt to find the balance, novel research continues. Immune cell function assays to measure patient cell-mediate immunity on an individual basis have not been successful (38) and the establishment of antigen-specific tolerance to the kidney transplant is not yet a reality in pediatrics (39).…”

Section: Reviewmentioning

confidence: 99%

Pediatric kidney transplantation: a historical review

Verghese

2016

Pediatr Res

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Successful renal transplantation is the optimal treatment for chronic kidney failure, but this was not always so for children. Beginning with the first kidney transplants in the 1950s, children experienced poorer patient and graft survival rates than adult patients. But over the last 6 decades, an improved understanding of the immune system which has steered pediatric multi-center clinical/pharmacokinetic and mechanistic studies that have sculpted our immunosuppression with markedly better patient and graft survivals. In addition, uniquely pediatric issues related to growth, development, neurocognitive maturation, increased complications from primary viral infections, and comorbid congenital/inherited disorders, are now diagnosed and effectively managed in these children. Refined pretransplant preparation (vaccinations for preventable diseases, attention to cognitive delays, effective dialysis and nutrition) improved donor selection, and more potent immunosuppression have all contributed to enhanced outcomes. Similarly, improvements in pediatric surgical techniques, postoperative care and better antiviral prophylaxis have all shortened hospitalizations and reduced morbidity. Today pediatric kidney transplant outcomes are markedly improved and younger children today experience better long-term graft survival than adults! While difficult problems remain, we have made tremendous progress and anticipate even more advances in the future of pediatric kidney transplantation.

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Section: Reviewmentioning

confidence: 99%

Pediatric kidney transplantation: a historical review

Verghese

2016

Pediatr Res

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“…While high ATP levels have been generally observed during the rejection process, no clear association has been shown with its predictive capacity over time(67). Furthermore, recent meta-analysis evaluating the predictive capacity of Immunknow in predicting the risk of infection and rejection demonstrate any value to identify patients at higher risk for both complications among different solid organ transplantation(68)(69)(70).…”

mentioning

confidence: 99%

Biomarkers to assess donor-reactive T-cell responses in kidney transplant patients

Crespo

Bestard

2016

Clinical Biochemistry

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“…ImmuKnow R uses PHA as a stimulant and measures the ATP that is produced by CD4+ T lymphocytes. Previous meta-analyses have not reached a consistent conclusion on the routine use of ImmuKnow R for prediction of infection in SOT recipients (55,56). A meta-analysis included ten studies and showed that ImmuKnow R could be used for the prediction of infections in liver transplant recipients (55).…”

Section: Discussionmentioning

confidence: 99%

Use of T Cell Mediated Immune Functional Assays for Adjustment of Immunosuppressive or Anti-infective Agents in Solid Organ Transplant Recipients: A Systematic Review

et al. 2020

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Background: Defining the optimal dosage of the immunosuppressive or duration of anti-infective agents is a challenge in solid organ transplant (SOT) recipients. We aimed to systematically review the literature regarding the use of T cell mediated immune functional assays (IFAs) for adjustment of the immunosuppressive or anti-infective agents in SOT recipients. Methods: We systematically searched PubMed, Scopus, EMBASE, Web of Science (WOS), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov to find human interventional studies or study protocols that used either in-house or commercially available IFAs for adjustment of the immunosuppressive or anti-infective agents in SOT recipients. Results: We included six clinical trials and six study protocols. Four out of the six clinical trials used interferon-γ release assays for cytomegalovirus (IGRA-CMV), and five out of the six registered study protocols planned to use IGRA-CMV for adjustment of anti-CMV antiviral (Valganciclovir) prophylaxis or preemptive therapy in SOT recipients. Primary or secondary anti-CMV prophylaxes were discontinued in SOT recipients who had positive IGRA-CMV results without an increase in the rate of CMV infection or reactivation. Among other IFAs, one clinical trial used interferon-γ release assays for tuberculosis (IGRA-TB), and one study used ImmuKnow for adjustment of the duration and dosage of isoniazid and tacrolimus, respectively. Conclusion: Our systematic review supports a promising role for the IGRA-CMVs for adjustment of the duration of anti-CMV antiviral prophylaxis in SOT recipients. There are limited data to support the use of IFAs other than IGRA-CMVs for adjustment of Rezahosseini et al. Immune Functional Assays in SOT-Recipients immunosuppressive or anti-infective agents. Further multicenter randomized clinical trials using IFAs other than IGRA-CMVs may help in personalized immunosuppressive or prophylactic anti-infective therapy in SOT recipients.

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Performance of the ImmuKnow Assay in Differentiating Infection and Acute Rejection After Kidney Transplantation: A Meta-Analysis

Cited by 19 publications

References 38 publications

Pediatric kidney transplantation: a historical review

Pediatric kidney transplantation: a historical review

Biomarkers to assess donor-reactive T-cell responses in kidney transplant patients

Use of T Cell Mediated Immune Functional Assays for Adjustment of Immunosuppressive or Anti-infective Agents in Solid Organ Transplant Recipients: A Systematic Review

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