{Reference Type}: Journal Article {Title}: Predictive Value of Immune Cell Functional Assay for Non-Cytomegalovirus Infection in Lung Transplant Recipients: A Multicenter Prospective Observational Study. {Author}: Monforte V;Ussetti P;Castejón R;Sintes H;Pérez VL;Laporta R;Sole A;Cifrián JM;Marcos PJ;Redel J;Arcos IL;Berastegui C;Alonso R;Rosado S;Escriva J;Iturbe D;Ovalle JP;Vaquero JM;López-Meseguer M;Mendoza A;Gómez-Ollés S;Monforte V;Ussetti P;Castejón R;Sintes H;Pérez VL;Laporta R;Sole A;Cifrián JM;Marcos PJ;Redel J;Arcos IL;Berastegui C;Alonso R;Rosado S;Escriva J;Iturbe D;Ovalle JP;Vaquero JM;López-Meseguer M;Mendoza A;Gómez-Ollés S; {Journal}: Arch Bronconeumol {Volume}: 57 {Issue}: 11 {Year}: Nov 2021 {Factor}: 6.333 {DOI}: 10.1016/j.arbr.2020.12.012 {Abstract}: BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.