Pre-transplant donor reactive IFN-γ producing cell and TGF-β producing cell frequencies and their clinical significance

Abstract

Objective To evaluate the frequencies of pre-transplant donor reactive IFN-γ and TGF-β producing cells using enzyme-linked immunosorbent (ELISPOT) assay and determine their cor-relation with the diagnosis of acute rejection and kidney graft function at 6 months post transplant. Methods One hundred and fifty-six kidney transplant recipients who were transplanted and followed up were enrolled. ELISPOT measurements of frequencies of donor reactive IFN-γ producing cells and TGF-β producing cells were carried out in pre-transplant peripheral blood lymphocyte (PBL) from the recipients as the responders, and splenocytes from the cadaveric donor or PBLs from live donor as stimulator cells. Patients with or without acute rejection episodes during the follow up were compared for the differences in IFN-γ and TGF-β ELISPOT values. Results Kidney transplant recipients who experienced acute rejection episodes had significantly higher IFN-γ ELISPOT than non-rejectors (mean rank 27.3 vs. 19.2, P=0.013). Forty-eight patients were defined as IFN-γ ELISPOT positive (>30/300 000), among whom 28(58%) had developed acute rejection, while only 25/108(23%) nega-tive patients had acute rejection (chi-square, P=0.007). Calculated glomerular filtration rate (Cock-eroft-Gault) was (73±16)ml/min in IFN-γ ELISPOT negative patients versus (53±15)ml/min in positive patients (P=0.005). Conclusions Pre-transplant IFN-γ ELISPOT can be served as a final cellular cross match test for kidney transplant recipients, which may be used by the clinicians to fur-ther improve donor and recipient pairing. Pre-transplant IFN-γ, ELISPOT correlated with kidney al-lograft function at 6 month post transplant, thereby may be a potential predictor for long-term out-comes and guide individualized treatment on a more rational basis. Key words: ELISPOT; IFN-γ; TGF-β; Kidney transplant recipients