Review
Copyright ©2014 Baishideng Publishing Group Co.
World J Transplant. Mar 24, 2014; 4(1): 30-39
Published online Mar 24, 2014. doi: 10.5500/wjt.v4.i1.30
Table 1 Clinically available immune monitoring after adult liver transplantati
SensitivitySpecificity
Currently available
Liver biochemistryHighLow
Therapeutic drug levelsLowLow
ImmuKnowLowHigh
Liver histologyGold standardGold standard
Future possibilities
PlexImmuneOnly Paedeatric studies published
? Combination assays
Table 2 Summary of assays for immune function monitoring
AdvantagesDisadvantages
Antigen-specific assays:Limiting dilution aAssays, mixed lymphocyte reactions, ELISPOTMeasure individual antigen specific responseNeed donor cells, Laboratory intensive
Antigen non-specific:ImmuKnowAvailable, FDA approvedInconsistent results
Cytokine levels/polymorphismsInconsistent results
Immune competence scoresReadily availableLack of published validation studies
Regulatory T cells (Tregs)Associated with rejectionLaboratory intensive. Lack of published validation studies
Soluble CD30Lack of association with clinical outcomes in OLTx
Identifying operational tolerant recipients:Tregs, Gene expression, dendritic cell types, delayed type hypersensitivityAble to identify recipients in whom immunosuppression could be withdrawnLaboratory intensive. Only few recipients suitable