Abstract
The ImmuKnow (IK) assay is a comprehensive immune function test that involves measuring adenosine triphosphate produced by the cluster of differentiation 4+ T lymphocytes in peripheral blood. The aim of this study was to analyze the time trends of IK values and assess the relationship between IK values and infections in lung transplants. We prospectively collected 178 blood samples from 22 deceased-donor lung transplant (DDLT) recipients and 17 living-donor lobar lung transplant (LDLLT) recipients. A surveillance IK assay was performed postoperatively, then after 1week and 1, 3, 6, and 12months. Time trends of IK values in stable recipients peaked 1week after DDLT (477±247 ATP ng/ml), and 1month after LDLLT (433±134ng/ml), followed by a gradual decline over 1year. The mean IK values in infections were significantly lower than those in the stable state (119 vs 312 ATP ng/ml, p=0.0002). IK values increased sharply after lung transplantation and then decreased gradually over time in the first year, suggesting a natural history of immune function. IK values were also significantly reduced during infections. These results may provide new insights into the utility of immune monitoring after lung transplantation.
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