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Review Article

Monitoring tolerance and rejection in organ transplant recipients

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Pages S42-S50 | Received 14 Dec 2010, Accepted 04 Apr 2011, Published online: 28 Jun 2011

Figures & data

Figure 1.  Overview on the type of immune cells and their respective function, which could be monitored in patients to predict transplant outcome. For cells of the adaptive and the innate immune systems, regulatory functions have been ascribed. Therefore, it is important to capture the relative proportion of potentially anti-inflammatory and inflammatory subpopulations of T cells, B cells, dendritic cells, and natural killer cells. Furthermore, if no changes in relative or absolute numbers are detectable, differences in functional competence or the secreted cytokine profile on stimulation with donor antigen might be revealed.

Figure 1.  Overview on the type of immune cells and their respective function, which could be monitored in patients to predict transplant outcome. For cells of the adaptive and the innate immune systems, regulatory functions have been ascribed. Therefore, it is important to capture the relative proportion of potentially anti-inflammatory and inflammatory subpopulations of T cells, B cells, dendritic cells, and natural killer cells. Furthermore, if no changes in relative or absolute numbers are detectable, differences in functional competence or the secreted cytokine profile on stimulation with donor antigen might be revealed.

Table 1.  Overview on compartments and assays used to perform immune monitoring.

Figure 2.  Frequency of donor-reactive IFNγ-producing T cells (ELISPOT) in peripheral blood mononuclear cells of renal transplant patients prior to transplantation experiencing acute rejection or no acute rejection.

Figure 2.  Frequency of donor-reactive IFNγ-producing T cells (ELISPOT) in peripheral blood mononuclear cells of renal transplant patients prior to transplantation experiencing acute rejection or no acute rejection.

Figure 3.  Combined qRT-PCR gene expression analysis of Foxp3 and α-1,2-mannosidase in whole blood samples of different kidney transplant patient groups of the “Indices of tolerance” consortium. HC, healthy controls; Tol-DF, tolerant drug free; s-LP, stale on low dose prednisolone; s-nCNI, stable on non-Calcineurin-inhibitor-based drugs; s-CNI, stable on Calcineurin inhibitors; CR, chronically rejecting patients.

Figure 3.  Combined qRT-PCR gene expression analysis of Foxp3 and α-1,2-mannosidase in whole blood samples of different kidney transplant patient groups of the “Indices of tolerance” consortium. HC, healthy controls; Tol-DF, tolerant drug free; s-LP, stale on low dose prednisolone; s-nCNI, stable on non-Calcineurin-inhibitor-based drugs; s-CNI, stable on Calcineurin inhibitors; CR, chronically rejecting patients.

Table 2.  Examples of biomarkers and assays that may be used for an immune monitoring of transplant patients.

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