Background: The ImmuKnow (IMK) assay is being considered as possible tool for identification of infection and rejection in transplant recipients. However, the predictive capability of IMK assay is still controversial. The aim of this study is to evaluate whether the IMK assay is useful for prediction of morbidity and mortality in living donor liver transplantation (LDLT) patients and living donor kidney transplantation (LDKT) patients.
Methods: One hundred six transplant patients (LDLT: n=72, LDKT: n=34) were randomly screened by using IMK and the 396 assays were performed from January 2011 to November 2012. All causes of morbidity and mortality were compared between the two groups: patients in whom at least one IMK activity showed below 225 ng/mL (low IMK) and in whom any IMK activities showed 225 ng/mL or more (high IMK).
Results: In the 72 LDLT patients, 23 (32%) belonged to low IMK group and 49 (68%) did to high IMK group. Although there was no differences in the levels of tacrolimus concentration and the frequency of rejection between the two groups (5.6 ng/m v.s. 6.3 ng/m, 13% v.s. 17%), the frequencies of Cytomegalovirus and bacterial infections were significantly higher in low IMK group than in high IMK group (43.5% v.s. 4.1%, p<0.001, 73.9% v.s. 6.4%, p<0.001). The 6-months mortality rate was 17.4% (4/23) in low IMK group and 0% in high IMK group (p<0.001), and the cause of death in all 4 cases was Cytomegalovirus and/or bacterial infection. In the 34 LDKT patients, 14 (41%) belonged to low IMK group and 20 (59%) did to high IMK group. There was no difference in the levels of tacrolimus concentration between the two groups (3.9 ng/m v.s. 4.3 ng/m), the frequency of infectious diseases (viral and bacterial) was significantly higher in low IMK group than in high IMK group (64.3% v.s. 25%, p=0.022). There was no mortality and rejection. The sensitivity and specificity of IMK assay for posttransplant infection were 0.850 and 0.882 in LDLT patients, while they were 0.643 and 0.750 in LDKT patients
Conclusions: The IMK assay is useful for prediction of posttransplant infection in LDKT as well as LDLT patients.
To cite this abstract in AMA style:Mizuno S, Nishikawa K, Muraki Y, Tanemura A, Kuriyama N, Osawa I, Azumi Y, Kishiwada M, Usui M, Sakurai H, Tabata M, Sugimura Y, Okuda M, Isaji S. Prediction of Morbidity and Mortality in Living Donor Liver Transplant and Living Donor Kidney Transplant Patients by Using Immune Function Assays [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/prediction-of-morbidity-and-mortality-in-living-donor-liver-transplant-and-living-donor-kidney-transplant-patients-by-using-immune-function-assays/. Accessed December 6, 2023.
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