Pre-transplant IFN-gamma ELISPOTs are associated with post-transplant renal function in African American renal transplant recipients

Am J Transplant. 2005 Aug;5(8):1971-5. doi: 10.1111/j.1600-6143.2005.00958.x.

Abstract

Final crossmatch testing is routinely used to assess the risk of antibody-mediated graft injury/rejection post-transplant. Analogously, we postulated that quantitative measurements of anti-donor effector/memory T cells pre-transplant would independently assess post-transplant risk. To address this hypothesis, we determined the frequencies of pre-transplant, donor-specific interferon-gamma (IFN-gamma) enzyme-linked immunosorbent spots (ELISPOTs) and correlated the results with post-transplant outcomes in 37 African American recipients of deceased donor kidney transplants treated with tacrolimus- and sirolimus-based immunosuppression. A positive ELISPOT test (>25 spots/300,000 cells) was detected in 14 (38%) of 37 patients. The incidence of biopsy-proven acute rejection was 50% (7/14) in ELISPOT-positive versus 17% (4/23) in ELISPOT-negative patients (p=0.036). Calculated glomerular filtration rate (MDRD) at 12 months was 37+/-16 mL/min in ELISPOT-positive versus 55+/-20 mL/min in ELISPOT-negative patients (p=0.01). ELISPOT status remained a correlate of allograft function at 12 months by linear regression analysis (p=0.001), independent of rejection and other contributing variables. Pre-transplant donor-directed IFN-gamma ELISPOT assessment of anti-donor cellular immunity may function as a 'cellular crossmatch' and independently correlates with renal allograft function in African Americans receiving tacrolimus- and sirolimus-based immunosuppression.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Graft Rejection
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interferon-gamma / analysis*
  • Interferon-gamma / metabolism
  • Kidney / physiology*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Sirolimus / therapeutic use
  • Tacrolimus / therapeutic use
  • Tissue Donors
  • Transplantation, Homologous

Substances

  • Immunosuppressive Agents
  • Interferon-gamma
  • Sirolimus
  • Tacrolimus