Liu Wei, Wang Kai, Zhao Yi-He, Song Guang-Ping, Gao Wei, Li Dai-Hong
Department of Blood Transfusion, Tianjin First Central Hospital, Tianjin 300192, P.R. China.
Department of Transplantation Surgery, Tianjin First Central Hospital, Tianjin 300192, P.R. China.
Exp Ther Med. 2019 Nov;18(5):3823-3828. doi: 10.3892/etm.2019.8003. Epub 2019 Sep 13.
The aim of the present study was to investigate the potential of the Immuknow immune cell function assay for the diagnosis of infection after pediatric living-donor liver transplantation (LDLT). Based on clinical data obtained following liver transplantation, 66 patients were divided into infection (n=28) and non-infection (n=38) groups. The following factors were considered in the present analysis: Primary disease, lymphocyte count, tacrolimus plasma concentration/dose (C/D) ratio, CD4 T lymphocyte ATP levels, at pre-transplant stage and at weeks 1-4, and 2 and 3 months post-transplant. The CD4 T lymphocyte ATP values were plotted in a receiver operating characteristic (ROC) curve. The CD4 T lymphocyte ATP value of the infection group was significantly lower compared with that of the non-infection group (188.6±93.5 vs. 424.4±198.1 ng/ml, respectively; P<0.05). No correlation was observed between the ATP value and tacrolimus plasma C/D ratio (R=0.0001484); however, a correlation was reported between the ATP value and lymphocyte count (R=0.2149). Analysis of the ROC curve indicated that the ATP levels of CD4 T cells were significantly associated with the diagnostic value of infection (area under the curve=0.866). These findings suggest that low CD4 T lymphocyte ATP levels may be an independent risk factor for infection following pediatric LDLT, and that the Immuknow assay may be used as a tool to evaluate T lymphocyte function in such patients to predict the risk of infection.
本研究的目的是探讨免疫状态监测（Immuknow）免疫细胞功能检测在小儿活体肝移植（LDLT）后感染诊断中的应用潜力。根据肝移植后的临床数据，将66例患者分为感染组（n = 28）和非感染组（n = 38）。本分析考虑了以下因素：原发病、淋巴细胞计数、他克莫司血药浓度/剂量（C/D）比值、移植前阶段以及移植后第1 - 4周、2个月和3个月时的CD4 T淋巴细胞ATP水平。将CD4 T淋巴细胞ATP值绘制在受试者工作特征（ROC）曲线中。感染组的CD4 T淋巴细胞ATP值显著低于非感染组（分别为188.6±93.5与424.4±198.1 ng/ml；P<0.05）。未观察到ATP值与他克莫司血药C/D比值之间存在相关性（R = 0.0001484）；然而，据报道ATP值与淋巴细胞计数之间存在相关性（R = 0.2149）。ROC曲线分析表明，CD4 T细胞的ATP水平与感染的诊断价值显著相关（曲线下面积 = 0.866）。这些发现表明，低CD4 T淋巴细胞ATP水平可能是小儿LDLT后感染的独立危险因素，并且免疫状态监测检测可作为评估此类患者T淋巴细胞功能以预测感染风险的工具。
