Pretransplant donor-specific helper T cell reactivity as a tool for tailoring the individual need for immunosuppression
| Autor: | B J, van der Mast, N M, van Besouw, P, de Kuiper, L M, Vaessen, P J, Gregoor, J N, IJzermans, T, van Gelder, F H, Claas, W, Weimar |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Graft Rejection Immunosuppression Therapy Male T-Lymphocytes Helper-Inducer In Vitro Techniques Middle Aged Hematopoietic Stem Cells Lymphocyte Activation Kidney Transplantation Tissue Donors HLA Antigens Acute Disease Tetanus Toxoid Humans Female Lymphocyte Culture Test Mixed Aged T-Lymphocytes Cytotoxic |
| Zdroj: | Transplantation. 72(5) |
| ISSN: | 0041-1337 |
| Popis: | A reliable immunological assay for quantification of donor-specific alloreactivity to identify patients at risk for future allograft rejection would be a helpful tool in organ transplantation. Therefore, we questioned whether the T cell reactivity in patients measured before transplantation was predictive for the occurrence of acute rejection during the first year after kidney transplantation.The pretransplant T cell reactivity of peripheral blood mononuclear cells to donor and third-party antigens was tested in mixed lymphocyte cultures, and to tetanus toxoid. In addition, we measured the frequency of donor and third-party reactive helper T lymphocyte precursor and cytotoxic T lymphocyte precursors using limiting dilution analysis.Patients who experienced acute rejection had significantly higher donor-specific mixed lymphocyte cultures responses (n=38; median stimulation index): 113 vs. 15, P=0.005) and helper T lymphocyte precursor frequency (n=37; median 194/106 vs. 62/106, P=0.009) measured before transplantation compared to patients without acute rejection. All patients with a low mixed lymphocyte culture response (stimulation index/=20; 13/13 vs. 12/25, P=0.001) and an undetectable helper T lymphocyte precursor frequency (10/106 peripheral blood mononuclear cells; 7/7 vs. 17/30, P=0.04) before transplantation did not experience acute rejection. The donor-specific cytotoxic T lymphocyte precursor frequency (n=34; median 53/106 vs. 28/106, P=0.58) and tetanus toxoid-reactivity (n=38; median stimulation index: 53 vs.16, P=0.56) measured before transplantation did not correlate with acute rejection. No correlation between third-party reactivity and acute rejection was observed.From these results we conclude that despite the current HLA matching criteria, undetectable helper T lymphocyte precursor frequency and low mixed lymphocyte culture responses against donor antigens measured before transplantation are predictive for a rejection-free first posttransplant year. These in vitro assays can be used to identify patients who require less immunosuppression after transplantation. |
| Databáze: | OpenAIRE |
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