Date: Tuesday, May 2, 2017
Session Name: Poster Session D: Kidney: Acute Cellular Rejection
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 June 5, 2020.
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