%0 Journal Article
%T Predictive Value of Immune Cell Functional Assay for Non-Cytomegalovirus Infection in Lung Transplant Recipients: A Multicenter Prospective Observational Study.
%A Monforte V
%A Ussetti P
%A Castejón R
%A Sintes H
%A Pérez VL
%A Laporta R
%A Sole A
%A Cifrián JM
%A Marcos PJ
%A Redel J
%A Arcos IL
%A Berastegui C
%A Alonso R
%A Rosado S
%A Escriva J
%A Iturbe D
%A Ovalle JP
%A Vaquero JM
%A López-Meseguer M
%A Mendoza A
%A Gómez-Ollés S
%J Arch Bronconeumol (Engl Ed)
%V 0
%N 0
%D Jan 2021 8
%M 33551278
暂无%R 10.1016/j.arbres.2020.12.024
%X <B>BACKGROUND: </B>Immune cell functional assay (ImmuKnow®) is a non-invasive method that measures the state of cellular immunity in immunosuppressed patients. We studied the prognostic value of the assay for predicting non-cytomegalovirus (CMV) infections in lung transplant recipients.<BR><B>METHODS: </B>A multicenter prospective observational study of 92 patients followed up from 6 to 12 months after transplantation was performed. Immune cell functional assay was carried out at 6, 8, 10, and 12 months.<BR><B>RESULTS: </B>Twenty-three patients (25%) developed 29 non-CMV infections between 6 and 12 months post-transplant. At 6 months, the immune response was moderate (ATP 225-525ng/mL) in 14 (15.2%) patients and low (ATP<225ng/mL) in 78 (84.8%); no patients had a strong response (ATP≥525ng/mL). Only 1 of 14 (7.1%) patients with a moderate response developed non-CMV infection in the following 6 months compared with 22 of 78 (28.2%) patients with low response, indicating sensitivity of 95.7%, specificity of 18.8%, positive predictive value (PPV) of 28.2%, and negative predictive value (NPV) of 92.9% (AUC 0.64; p=0.043). Similar acute rejection rates were recorded in patients with mean ATP≥225 vs. <225ng/mL during the study period (7.1% vs. 9.1%, p=0.81).<BR><B>CONCLUSIONS: </B>Although ImmuKnow® does not seem useful to predict non-CMV infection, it could identify patients with a very low risk and help us define a target for an optimal immunosuppression.