Peripheral natural killer cell and allo-stimulated T-cell function in kidney transplant recipients associate with cancer risk and immunosuppression-related complications

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dc.contributor.authorHope, C.
dc.contributor.authorTroelnikov, A.
dc.contributor.authorHanf, W.
dc.contributor.authorJesudason, S.
dc.contributor.authorCoates, P.
dc.contributor.authorHeeger, P.
dc.contributor.authorCarroll, R.
dc.date.issued2015
dc.descriptionAdvance online publication 12 August 2015
dc.description.abstractReducing 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.
dc.description.statementofresponsibilityChristopher M Hope, Alexander Troelnikov, William Hanf, Shilpanjali Jesudason, Patrick T Coates, Peter S Heeger, and Robert P Carroll
dc.identifier.citationKidney International, 2015; 88(6):1374-1382
dc.identifier.doi10.1038/ki.2015.237
dc.identifier.issn0085-2538
dc.identifier.issn1523-1755
dc.identifier.orcidHope, C. [0000-0001-8206-1939]
dc.identifier.orcidJesudason, S. [0000-0001-9695-0761]
dc.identifier.orcidCarroll, R. [0000-0002-6238-026X]
dc.identifier.urihttp://hdl.handle.net/2440/93712
dc.language.isoen
dc.publisherNature Publishing Group
dc.rights© 2015 International Society of Nephrology
dc.source.urihttps://doi.org/10.1038/ki.2015.237
dc.subjectcancer; IFN-γ ELISPOT; immunosuppression; kidney transplantation; NK cells
dc.titlePeripheral natural killer cell and allo-stimulated T-cell function in kidney transplant recipients associate with cancer risk and immunosuppression-related complications
dc.typeJournal article
pubs.publication-statusPublished

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