Utility of the Cylex Assay in Cardiac Transplant Recipients

Gupta, Sachin; Mitchell, Joshua D.; Markham, David W.; Mammen, Pradeep P.A.; Patel, Parag C.; Kaiser, Patricia A.; Šťastný, Peter; Ring, W. Steves; DiMaio, J. Michael; Drazner, Mark H.

doi:10.1016/j.healun.2008.05.014

Cited by 34 publications

(34 citation statements)

References 9 publications

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“…9 The major contention in this study was the very small number of infection (n ϭ 7) and rejection (n ϭ 1) episodes. With such small numbers, significant correlations would be difficult.…”

Section: Discussionmentioning

confidence: 91%

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Benefit of immune monitoring in heart transplant patients using ATP production in activated lymphocytes

Kobashigawa¹,

Kiyosaki²,

Patel³

et al. 2010

The Journal of Heart and Lung Transplantation

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“…9 The major contention in this study was the very small number of infection (n ϭ 7) and rejection (n ϭ 1) episodes. With such small numbers, significant correlations would be difficult.…”

Section: Discussionmentioning

confidence: 91%

“…8 However, in a recent study by Gupta et al, involving 111 heart transplant patients, scores did not correlate with infection (n ϭ 7) or rejection (n ϭ 1). 9 The purpose of the current study was to investigate the utility of this IM assay in a large number of heart transplant recipients at our institution.…”

mentioning

confidence: 99%

Benefit of immune monitoring in heart transplant patients using ATP production in activated lymphocytes

Kobashigawa¹,

Kiyosaki²,

Patel³

et al. 2010

The Journal of Heart and Lung Transplantation

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“…As reported, the Cylex ImmuKnow assay has a high predictive value and provides a target immunological response level for minimizing the risk of post-transplant infection and rejection in solid organ transplantation (Kowalski et al 2006;Husain et al 2009;Bhorade et al 2008). However, a few studies have indicated that the immune function assay has a very limited role in assessing the risk of infection or rejection in cardiac transplant recipients (Gupta et al 2008;Rossano et al 2009) and the risk of rejection in renal transplantation after Thymoglobulin induction therapy (Serban et al 2009). In our ROC analysis, we found that the immune function assay was helpful in the diagnosis of infection and rejection with acceptable levels of sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma

Shi

Fan

Huang

et al. 2011

J Cancer Res Clin Oncol

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“…An alternative indicator could be CD4 + T cell activation, which the Cylex ImmuKnow assay was designed to measure. This assay was never embraced clinically, because its utility was never definitively demonstrated (31,32). Therefore, in the absence of a clinically useful and validated measure of immunosuppression, the tacrolimus trough level has become the standard.…”

Section: Discussionmentioning

confidence: 99%

Individualizing liver transplant immunosuppression using a phenotypic personalized medicine platform

et al. 2016

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Posttransplant immunosuppressive drugs such as tacrolimus have narrow therapeutic ranges. Inter-and intraindividual variability in dosing requirements conventionally use physician-guided titrated drug administration, which results in frequent deviations from the target trough ranges, particularly during the critical postoperative phase. There is a clear need for personalized management of posttransplant regimens to prevent adverse events and allow the patient to be discharged sooner. We have developed the parabolic personalized dosing (PPD) platform, which is a surface represented by a second-order algebraic equation with experimentally determined coefficients of the equation being unique to each patient. PPD uses clinical data, including blood concentrations of tacrolimus-the primary phenotypic readout for immunosuppression efficacy-to calibrate these coefficients and pinpoint the optimal doses that result in the desired patient-specific response. In this pilot randomized controlled trial, we compared four transplant patients prospectively treated with tacrolimus using PPD with four control patients treated according to the standard of care (physician guidance). Using phenotype to personalize tacrolimus dosing, PPD effectively managed patients by keeping tacrolimus blood trough levels within the target ranges. In a retrospective analysis of the control patients, PPD-optimized prednisone and tacrolimus dosing improved tacrolimus trough-level management and minimized the need to recalibrate dosing after regimen changes. PPD is independent of disease mechanism and is agnostic of indication and could therefore apply beyond transplant medicine to dosing for cancer, infectious diseases, and cardiovascular medicine, where patient response is variable and requires careful adjustments through optimized inputs.

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Utility of the Cylex Assay in Cardiac Transplant Recipients

Cited by 34 publications

References 9 publications

Benefit of immune monitoring in heart transplant patients using ATP production in activated lymphocytes

Benefit of immune monitoring in heart transplant patients using ATP production in activated lymphocytes

An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma

Individualizing liver transplant immunosuppression using a phenotypic personalized medicine platform

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