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Type: Journal article
Title: Peripheral natural killer cell and allo-stimulated T-cell function in kidney transplant recipients associate with cancer risk and immunosuppression-related complications
Author: Hope, C.
Troelnikov, A.
Hanf, W.
Jesudason, S.
Coates, P.
Heeger, P.
Carroll, R.
Citation: Kidney International, 2015; 88(6):1374-1382
Publisher: Nature Publishing Group
Issue Date: 2015
ISSN: 0085-2538
Statement of
Christopher M Hope, Alexander Troelnikov, William Hanf, Shilpanjali Jesudason, Patrick T Coates, Peter S Heeger, and Robert P Carroll
Abstract: Reducing immunosuppression has been proposed as a means of preventing cancer in kidney transplant recipients but this can precipitate graft rejection. Here we tested whether anti-tumor natural killer (NK) cell and allo-responsive T-cell function in kidney transplant recipients may predict cancer risk and define risk of rejection. NK cell function was measured by the release of lactate dehydrogenase and T-cell allo-response by interferon-γ quantification using a panel of reactive T-cell enzyme-linked immunospot (ELISPOT) in 56 kidney transplant recipients with current or past cancer and 26 kidney transplant recipients without cancer. NK function was significantly impaired and the allo-response was significantly lower in kidney transplant recipients with cancer. With prospective follow-up, kidney transplant recipients with poor NK cell function had a hazard ratio of 2.1 (95% confidence interval 0.97-5.00) for the combined end point of metastatic cancer, cancer-related death, or septic death. Kidney transplant recipients with low interferon-γ release were also more likely to reach this combined end point. Thus, posttransplant monitoring of allo-immunity and NK cell function is useful for assessing the risk of over immunosuppression for the development of malignancy and/or death from cancer or sepsis.
Keywords: cancer; IFN-γ ELISPOT; immunosuppression; kidney transplantation; NK cells
Description: Advance online publication 12 August 2015
Rights: © 2015 International Society of Nephrology
RMID: 0030032835
DOI: 10.1038/ki.2015.237
Appears in Collections:Medicine publications

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