Victoria Socha

DocwireNews

American Transplant Congress 2021In a virtual presentation at the American Transplant Congress 2021, Y. Sambandam and colleagues reported interim results of a single-center, nonrandomized prospective study designed to test the hypothesis that <a href="https://www.docwirenews.com/nephtimes/nephtimes-conferences/transplant-congress/s2-as-marker-of-kidney-function-in-patients-with-delayed-graft-function/">kidney transplant</a> rejection can be diagnosed by monitoring for donor reactive T-cell (DRTC) clones in a post-transplant biopsy and noninvasively in blood and urine samples. The presentation was titled Kidney Transplant Rejection Can Be Diagnosed or Even Predicted by Tracking Donor Reactive T-cell Clones in Post-Transplant Samples.From a pretransplant anti-donor mixed lymphocyte reaction (MLR) assay, CFSE-diluting CD4 and CD8 DRTCs were flow-sorted and immunoSEQ&reg; Assay was used to identify the T-cell receptor (TcR) clonal sequences (collectively called TcR-AlloSEQ). The premise was that TcR-AlloSEQ would identify the recipient&rsquo;s anti-donor T-cells.During the post-transplant period, the presence and abundance of the pre-identified DRTCs were serially monitored via immunoSEQ in kidney transplant biopsies at 3 and 12 months, and for cause, as well as in blood and urine samples at 3, 6, and 12 months and for cause.In results of 30 of 80 standard of care kidney transplant recipients, patients were categorized as stable (n=18), rejecting (n=5), and other causes (n=7). Clones were identified as donor reactive in both CD4 and CD8 subsets from pretransplant MLR; the DTRCs were primarily from low-frequency clones in the recipient peripheral blood mononuclear cell.DRTCs of both subsets could be detected variably in all post-transplant samples. Recipients in the stable group had low DRTCs and those in the rejecting group had significantly (P&lt;.002) elevated DRTCs at months 3 and 6, and rejection in biopsy, and in blood and urine sample tests. The increase in each rejecting biopsy suggested possible use in acute rejection diagnosis.&nbsp; The increases in the blood and urine samples also suggested that rejection diagnosis is possible noninvasively.The 3-month post-transplant observation of increase in DRTCs was a predictor of biopsy-proven acute rejection in three of five patients. The rejection was resolved via dosage changes of tacrolimus, mycophenolate mofetil, and prednisone along with intravenous immunoglobulin or belatacept treatment. The dosage changes also resulted in a marked decrease in the presence of DRTCs in samples at 12-months of follow-up.In conclusion, the researchers said, &ldquo;These interim results suggested that monitoring for DRTCs can diagnose an ongoing rejection and can even predict an upcoming rejection and that this can be achieved noninvasively in blood or urine. Completion of the whole study is expected to provide more insights.&rdquo;Source: Sambandam Y, Kandpal M, He J, et al. Kidney transplant rejection can be diagnosed or even predicted by tracking donor reactive T cell clones in post-transplant samples. Abstract of a presentation at the virtual American Transplant Congress 2021 (abstract #224), June 7, 2021.

Bradley Warady, MD

Joel M. Topf, MD, FACP

2025 Hume Award Winner Is Dedicated to Children’s Care

NKF Spring Clinical Meetings 2025

Jordana Jampel

Distant Brain Metastases in Cutaneous Melanoma May Be Mitigated With Multiple Pathway Inhibitors

Melanoma

Eric Bergson, MD

Rob Dillard

The Role of Multidisciplinary Care in Head and Neck Cancer

Head and Neck Cancer

Latest News

Donor Reactive T-Cell Clones to Diagnose and Predict Rejection

American Transplant Congress 2021

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe