Stratification of Kidney Transplant Recipients into Those with Low and High Alloreactive T-Cells May Allow Safe Conversion to mTOR-Inhibitor-Based Immunosuppression.
1Nephrology and Internal Intensive Care, Charite Campus Virchow Clinic, Berlin, Germany
2Berlin-Brandenburg Center for Regenerative Therapies, Charite Campus Virchow Clinic, Berlin, Germany.
Meeting: 2016 American Transplant Congress
Abstract number: B111
Keywords: Allorecognition, Immunosuppression
Session Information
Session Name: Poster Session B: Drug Minimization
Session Type: Poster Session
Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
ZEUS and Herakles study randomized kidney transplant recipients (KTRs) to either continue cyclosporine or convert to everolimus posttransplantation with favorable long-term outcomes in the conversion group but higher incidences of early acute rejection.
We analyzed 35 KTRs who were enrolled in either the ZEUS or Herakles study.Among these 35 KTRs, 14 KTRs (40%) continued cyclosporine, 14 KTR (40%) were converted to everolimus, and 7 KTRs (20%) were excluded from randomization due to early acute rejection. Samples were collected pretransplantation, at +1, +2, and +3 months posttransplantation, and alloreactive T-cells were measured using an interferon-γ Elispot assay.
10 KTRs (29%) showed high and 25 KTRs (71%) showed low alloreactive T-cells pretransplantation. Among KTRs with low alloreactive T-cells, 13 KTRs (52%) were converted to everolimus, and 12 KTRs (48%) continued cyclosporine. Among those converted to everolimus, 1 KTRs (7.7%) developed acute rejection post-randomization. Among those who continued cyclosporine 1 KTRs (8.3%) developed acute rejection pre-randomization, and 2 KTRs (16.7%) developed acute rejection post-randomization (p=0.593). Among KTRs with high alloreactive T-cells, 8 KTRs (80%) developed acute cellular rejection pre-randomization and 7 KTRs were switched to tacrolimus-based regimes. Those 2 KTRs without acute rejection continued cyclosporine and didn't develop acute rejection in follow-up. No differences were observed for patient survival or allograft survival (p>0.05).
The stratification of KTRs into those with high and low alloreactive T-cells may prove useful to identify KTRs suitable for conversion to mTOR-inhibitor-based immunosuppression. Caution should be taken in KTRs with high alloreactive T-cells with regards to minimizing immunosuppression.
CITATION INFORMATION: Schachtner T, Stein M, Reinke P. Stratification of Kidney Transplant Recipients into Those with Low and High Alloreactive T-Cells May Allow Safe Conversion to mTOR-Inhibitor-Based Immunosuppression. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Schachtner T, Stein M, Reinke P. Stratification of Kidney Transplant Recipients into Those with Low and High Alloreactive T-Cells May Allow Safe Conversion to mTOR-Inhibitor-Based Immunosuppression. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/stratification-of-kidney-transplant-recipients-into-those-with-low-and-high-alloreactive-t-cells-may-allow-safe-conversion-to-mtor-inhibitor-based-immunosuppression/. Accessed May 16, 2025.« Back to 2016 American Transplant Congress