Utility of immune monitoring in heart transplant recipients on everolimus-based immune suppression.
Clin Transplant
; 28(4): 428-33, 2014 Apr.
Article
en En
| MEDLINE
| ID: mdl-24649896
ABSTRACT
BACKGROUND:
Everolimus provides effective immune suppression (IS) after heart transplant (HTx). Its pharmacologic properties differentiate everolimus from other IS drugs. A non-invasive immune monitoring (IM) assay test appears to predict the immune state in HTx recipients on standard calcineurin-inhibitor-based IS. The utility of IM in HTx recipients on everolimus-based IS was evaluated.METHODS:
Between June 2005 and June 2011, 34 adult HTx recipients followed up at our center received everolimus and had 381 IM assays that were performed at six months to 16-yr post-transplant. Results of the IM assay were correlated with infection and rejection episodes that occurred during the IM testing.RESULTS:
In the everolimus-based IS group, there were 18 infectious episodes and four rejection episodes. The average IM score was significantly lower during infection than at steady state (188 ± 122 vs. 338 ± 137 ng/mL ATP, p < 0.001) and not significantly different during rejection when compared with steady state (430 ± 132 vs. 338 ± 137 ng/mL ATP, p = 0.5).CONCLUSIONS:
The non-invasive IM assay predicts infectious risk in HTx recipients on everolimus-based IS. Its inconclusive association with rejection was probably due to the small number of rejections. Serial longitudinal IM may allow proper adjustment of everolimus doses.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Monitorización Inmunológica
/
Trasplante de Corazón
/
Huésped Inmunocomprometido
/
Sirolimus
/
Rechazo de Injerto
/
Inmunosupresores
/
Infecciones
Tipo de estudio:
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2014
Tipo del documento:
Article
País de afiliación:
Israel