Immunosuppression Modifications Based on an Immune Response Assay: Results of a Randomized, Controlled Trial

Transplantation
Matteo RavaioliAntonio D Pinna

Abstract

An immune function assay shows promise for identifying solid organ recipients at risk for infection or rejection. The following randomized prospective study was designed to assess the clinical benefits of adjusting immunosuppressive therapy in liver recipients based on immune function assay results. Adult liver recipients were randomized to standard practice (control group; n = 102) or serial immune function testing (interventional group; n = 100) performed with a commercially available in vitro diagnostic assay (ImmuKnow; Viracor-IBT Laboratories, Lee's Summit, MO) before transplantation, immediately after surgery and at day 1, weeks 1 to 4, 6, and 8, and months 3 to 6, 9, and 12. The assay was repeated within 7 days of suspected/confirmed rejection/infection and within 1 week after event resolution. Based on immune function values, tacrolimus doses were reduced 25% when values were less than 130 ng/mL adenosine triphosphate (low immune cell response) and increased 25% when values were greater than 450 ng/mL adenosine triphosphate (strong immune cell response). The 1-year patient survival was significantly higher in the interventional arm (95% vs 82%; P < 0.01) and the incidence of infections longer than 14 days after transpla...Continue Reading

Associated Clinical Trials

References

Mar 1, 1992·Chest·R C Bone
Dec 16, 1997·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·R G LeeA J Demetris
Jan 24, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A HumarUNKNOWN AST ID Working Group on Infectious Disease Monitoring
Apr 1, 2006·Transplant International : Official Journal of the European Society for Organ Transplantation·Gerd R SilberhumerGabriela A Berlakovich
Jul 11, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M RavaioliA D Pinna
Dec 21, 2007·The New England Journal of Medicine·Jay A Fishman
Aug 30, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Michel MendlerOkechukwu Ojogho
Aug 30, 2008·World Journal of Gastroenterology : WJG·Raymund Rabe Razonable
Jan 30, 2009·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Roniel CabreraGiuseppe Morelli
Feb 25, 2009·Seminars in Liver Disease·George Mells, James Neuberger
Feb 6, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jon A KobashigawaAbbas A Ardehali
Jul 20, 2010·Clinical Transplantation·Tadahiro UemuraZakiyah Kadry
Jan 15, 2011·Transplant Immunology·David BerglundGunnar Tufveson
May 5, 2012·Clinical Transplantation·Helen S TeDonald M Jensen
Jun 29, 2012·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Emilio RodrigoManuel Arias
Feb 5, 2013·EJNMMI Research·Alberto Signore
Apr 23, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P De SimoneF Saliba
Jun 26, 2013·Annals of Transplantation : Quarterly of the Polish Transplantation Society·Takayuki TanakaSusumu Eguchi

❮ Previous
Next ❯

Citations

Dec 23, 2015·Korean Journal of Hepato-biliary-pancreatic Surgery·Eunkyoung JwaSung-Gyu Lee
May 4, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Richard ChengJon A Kobashigawa
May 21, 2016·International Journal of Clinical Practice·W ZhangS Zheng
Dec 30, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Manuel Rodríguez-PerálvarezJan Lerut
Oct 11, 2016·Journal of Immunological Methods·Thibaut GirardotFabienne Venet
Oct 18, 2016·Annals of Surgery·Matteo RavaioliAntonio D Pinna
Oct 27, 2016·Medical Microbiology and Immunology·Angela ChiereghinTiziana Lazzarotto
Jan 26, 2017·The British Journal of Surgery·V R BertuzzoM Cescon
May 26, 2017·Current Opinion in Organ Transplantation·Stephanie A K AngaritaFady M Kaldas
Jan 23, 2019·The Journal of Infectious Diseases·Robert StrasslGregor Bond
Jan 8, 2017·Journal of the American Society of Nephrology : JASN·Madhav C MenonPeter S Heeger
May 3, 2019·Therapeutic Drug Monitoring·Mercè BrunetStein Bergan
Feb 23, 2020·Expert Review of Anti-infective Therapy·Mario Fernández-RuizJosé María Aguado
Feb 9, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Konstantin DobererGregor Bond
Mar 1, 2020·The Journal of Infectious Diseases·Rafael San-JuanUNKNOWN Spanish Network for Research in Infectious Diseases (Red Española de Investigación en Patología Infecciosa [REIPI] RD16/0016
Jan 11, 2017·Journal of Immunology Research·Giulia AquilanoTiziana Lazzarotto
Jul 12, 2018·Current Cardiology Reports·Luciano PotenaArezu Aliabadi-Zuckermann
Mar 15, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ana Fernández-CruzDimitrios P Kontoyiannis
Jul 15, 2018·The Journal of Infectious Diseases·Camille Nelson Kotton
Sep 20, 2018·World Journal of Gastroenterology : WJG·Jian-Wen JiangLan-Juan Li
Nov 22, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Ricardo M La HozDavid E Greenberg
Dec 23, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Bradley J GardinerGlen P Westall
Jan 23, 2021·Journal of Nephrology·Irene FaravelliClaudio Ponticelli
Jun 8, 2021·Frontiers in Immunology·Xingqiang LaiZheng Jenny Zhang
Jul 27, 2021·Molecular and Cellular Pediatrics·Thurid Ahlenstiel-Grunow, Lars Pape
Apr 10, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Daniele DondossolaGiorgio Rossi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Adrenocortical Carcinoma

Hepatocellular carcinoma is the most common type of primary liver cancer and frequently occurs in individuals with chronic liver diseases like cirrhosis. Here is the latest research.