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Use of an immune function assay to monitor immunosuppression for treatment of post‐transplant lymphoproliferative disorder
Author(s) -
Gautam Amitabh,
Morrissey Paul E.,
Brem Andrew S.,
Fischer Staci A.,
Gohh Reginald Y.,
Yango Angelito F.,
Monaco Anthony P.
Publication year - 2006
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2006.00510.x
Subject(s) - immunosuppression , medicine , post transplant lymphoproliferative disorder , immune system , immunology , lymphoproliferative disorders , lymphoproliferative response , kidney transplantation , transplantation , virus , epstein–barr virus , biology , in vitro , peripheral blood mononuclear cell , biochemistry , lymphoma
The first‐line treatment for PTLD is reduction in immunosuppression, allowing partial reconstitution of cell‐mediated immunity. However, there is a risk of inducing acute allograft rejection during clinical resolution of PTLD. A recently available assay, Immuknow TM , measures the cell‐mediated immune response and could be used to monitor reduction of immunosuppression. We report a case of PTLD occurring in a pediatric kidney transplant recipient where the reduction in immunosuppression was serially followed using this assay and quantitative EBV‐PCR. A rapid reduction to minimal immunosuppression was followed by resolution of PTLD. Later, when the cell‐mediated immune response increased, with negative viral load, immunosuppression was gradually increased utilizing the assay to adjust dosing. Presently, there are no signs of PTLD and renal function remains normal.