Abstract:
INTRODUCTION:Because of the necessary immunosuppression, transplant recipients have a high risk of infection. Conversely, underimmunosuppression carries with it the risk of rejection. It would be quite useful to have a test that could differentiate between infection and rejection in renal transplant patients and better still, to predict which patients are at risk of complications. A new assay, which measures adenosine triphosphate (ATP) synthesis by CD4+ T cells in response to stimulation by phytohemagglutinine (Immuknow assay, Cylex, Inc) is undergoing clinical evaluations. Preliminary investigations suggest that this test could be useful to assess and predict the immune status of patients with other conditions. METHODS:We examined the records of all patients who received a kidney transplant in our program between August 2004 and January 2005. Of 64 patients, 58 had pretransplant and posttransplant ATP level determinations. We searched for associations between ATP levels and immunosuppression type, doses, and levels; creatinine levels; white blood cell count; tissue typing; preformed antibodies; as well as ATP levels on infection and rejection, and changes in ATP levels with time. Chi-square, Fisher, t test, analysis of variance (ANOVA), and relative risks were used for analysis of data. RESULTS:There was no relation between ATP levels and immunosuppression type, doses, or levels; creatinine levels; white blood cell counts; HLA; and panel-reactive antibody (P > 0.05). However, patients with moderate or high pretransplant ATP levels had more rejection episodes (8/10) while patients with ATP levels in the low immune response had more infections (6/11) (P < .001; relative risk [RR] for rejection = 1.2; RR for infection = 4.4). The mean ATP levels for rejection was 423.3 ng/mL versus 268.45 ng/mL for infection and 277.15 ng/mL for no events (ANOVA, P = .0145). Although acute rejections occurred mostly above 300, this was not significant (P = .059; RR = 0.9). Infections were more frequent with ATP under 300 (RR = 7.3) and severe infection (endocarditis, meningitis, peritoneal abscesses, pneumonia, etc) were more frequent under 200 (P < .001). Comparing pretransplant with posttransplant values at the second week an increase correlated with rejection (P < .001, RR = 15.3), while a decrease did not correlate with the infection (P = .845, RR = 1.4). Patients who received antirejection treatment had a decrease in their ATP levels at 5 days (P = .002). CONCLUSION:This ATP release assays helpful in determining the risk of developing infection or rejection, as well as follow-up in the response to therapy.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Cadillo-Chávez R,de Echegaray S,Santiago-Delpín EA,Rodríguez-Trinidad AT,Camacho-Carrazo B,Alfaro T,Saavedra-Pozo M,Carrasquillo L,González-Caraballo ZA,Morales-Otero LAdoi
10.1016/j.transproceed.2006.02.051subject
Has Abstractpub_date
2006-04-01 00:00:00pages
918-20issue
3eissn
0041-1345issn
1873-2623pii
S0041-1345(06)00142-4journal_volume
38pub_type
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journal_title:Transplantation proceedings
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abstract:OBJECTIVES:Organ preservation is one of the important steps that predicts the patient outcome. However, after revascularization, the high concentration of potassium that influxes into the circulation might cause immediate postreperfusion hyperkalemia. To prevent this complication, the portal vein has been washed out wi...
journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
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doi:10.1016/j.transproceed.2005.01.027
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abstract:BACKGROUND:Chronic active antibody-mediated rejection (CAMR) is an important cause of chronic kidney allograft dysfunction, but there has been no effective treatment protocol established for it. METHODS:Six renal transplant recipients who showed progressive deterioration in graft function and CAMR as diagnosed by biop...
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.01.033
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abstract:BACKGROUND:It is unclear whether both Kidney Donor Profile Index (KDPI) and Kidney Donor Risk Index (KDRI) scores can be applied to elderly deceased donors (DDs). This study aimed to compare the predictive values of KDRI and KDPI for the occurrence of delayed graft function (DGF) in kidney transplantation (KT) from eld...
journal_title:Transplantation proceedings
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abstract:INTRODUCTION:Diagnosis of thyroid disease is fundamental in the evaluation of patients awaiting kidney transplantation. We analyzed the incidence of thyroid disease in patients with end-stage renal disease (ESRD) and evaluated its evolution before and after kidney transplantation. PATIENTS AND METHODS:Between January ...
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更新日期:2009-05-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Nowadays, hepatic ischemia reperfusion (HI/R) injury is regarded as a serious concern in clinical practices. Huperzine A (HupA) is an alkaloid isolated from the Chinese folk medicine huperzia serrate, which has possessed diverse pharmacological actions. METHODS:A mouse model of HI/R was caused by clamping t...
journal_title:Transplantation proceedings
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pub_type: 杂志文章
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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更新日期:2010-07-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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abstract::Cinacalcet is a calcimimetic drug that has been approved for treatment of secondary and tertiary hyperparathyroidism in patients with renal failure requiring renal replacement therapy. A few cases of successful treatment in renal transplant patients immunosuppressed with cyclosporine have been reported. Herein we have...
journal_title:Transplantation proceedings
pub_type: 杂志文章
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