A Prospective Observational Study to Evaluate Use of a Panel of Reactive T Cell (PRT) Assay as a Pre-Transplant Marker of Rejection in Kidney Transplant Recipients.
1Washington University, St. Louis, MO
2Erie County Medical Center, Buffalo, NY
3Massachusetts General Hospital, Boston, MA
4Washington University, Seattle, WA
5Houston Methodist, Houston, TX
6Oxford Immunotec, Oxfordshire, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: D119
Keywords: HLA antigens, Kidney transplantation, Rejection, T cell reactivity
Session Information
Session Name: Poster Session D: Kidney: Acute Cellular Rejection
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background:To assess risk of T cell mediated acute rejection a recently developed assay uses a panel of reactive T cell lines (PRT) to measure recipient pre-transplant T cell responses. This study correlated PRT ELISPOT assay responses with acute rejection events.
Methods: This is a 43 site, prospective, observational study of 600 adult kidney transplant recipients. Patient management was according to institutional protocols. Pre-transplant PRA and date and severity of post-transplant acute rejection events, using Banff criteria were recorded. T cell responses were analyzed pre-, and every 3 months post-transplant for 1 year. The ELISPOT assay uses 6 primary B cell lines as stimulators to evoke T cell responses in recipient PBMCs (T-SPOT®.PRT, Oxford Diagnostic Laboratories®, TN, USA). The data are expressed as interferon gamma-mediated spot counts from recipient cells for patients reaching ≥6 months post-transplant.
Results: Pre-transplant PRT assay was performed within two weeks prior to transplant and 112 recipients had both a valid pre-transplant T-SPOT.PRT result and 6 months follow up data for analysis. ATG induction therapy was given to 66 (58.9%) of recipients; the PRA result was zero in 63.4% of recipients. 8/112 (7.1%) recipients experienced an acute rejection event; 7 of these were within 3 months post-transplant. All 7 received ATG induction and 4 of these had zero PRA response pre-transplant; 6 of the 8 recipients with an acute rejection event had high and consistent levels of response in the PRT.
| Average pre-transplant total PRT spot count | Average eGFR at 6 mo post-tansplant | Average pre-transplant PRA value | |
| Subjects with acute rejection event | 721 (n=8) | 51.13 (n=8) | 44.67 (n=3) |
| Subject without acute rejection event | 509 (n=104 | 54.63 (n=75) | 53.69 (n=36) |
Conclusion: An interim analysis of the data comparing acute rejection events with responses in the PRT test has not yet yielded sufficient events to draw clear conclusions however there is a trend towards lower PRT results linked to absence of acute rejection. Follow-up is ongoing.
CITATION INFORMATION: Brennan D, Kayler L, Wojciechowski D, Limaye A, Gaber A, Durrant I. A Prospective Observational Study to Evaluate Use of a Panel of Reactive T Cell (PRT) Assay as a Pre-Transplant Marker of Rejection in Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Brennan D, Kayler L, Wojciechowski D, Limaye A, Gaber A, Durrant I. A Prospective Observational Study to Evaluate Use of a Panel of Reactive T Cell (PRT) Assay as a Pre-Transplant Marker of Rejection in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/a-prospective-observational-study-to-evaluate-use-of-a-panel-of-reactive-t-cell-prt-assay-as-a-pre-transplant-marker-of-rejection-in-kidney-transplant-recipients/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress