The Journal of Heart and Lung Transplantation
Volume 29, Issue 5 , Pages 504-508 , May 2010

Benefit of immune monitoring in heart transplant patients using ATP production in activated lymphocytes

  • Jon A. Kobashigawa, MD

      Affiliations

    • Division of Cedars-Sinai Heart Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    • Corresponding Author InformationReprint requests: Jon A. Kobashigawa, MD, Cedars-Sinai Heart Institute, 8700 Beverly Boulevard, Los Angeles, CA 90048. Telephone: 310-248-8300. Fax: 310-248-8333
    • ,
  • Krista K. Kiyosaki, BA

      Affiliations

    • Division of Cedars-Sinai Heart Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    • ,
  • Jignesh K. Patel, MD, PhD

      Affiliations

    • Division of Cedars-Sinai Heart Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    • ,
  • Michelle M. Kittleson, MD, PhD

      Affiliations

    • Division of Cedars-Sinai Heart Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    • ,
  • Bernard M. Kubak, MD

      Affiliations

    • Division of Infectious Disease, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    • ,
  • Stephanie N. Davis, BS

      Affiliations

    • Division of Cedars-Sinai Heart Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    • ,
  • Matt A. Kawano, BS

      Affiliations

    • Division of Cedars-Sinai Heart Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    • ,
  • Abbas A. Ardehali, MD

      Affiliations

    • Division of Cardiothoracic Surgery, Department of Surgery, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California

  • Image Result

    Average IM scores in steady-state patients compared with those with infection or rejection within 1 month after IM test. Interestingly, 3 of 8 rejection episodes were antibody-mediated and had hemodyn

    Average IM scores in steady-state patients compared with those with infection or rejection within 1 month after IM test. Interestingly, 3 of 8 rejection episodes were antibody-mediated and had hemodynamic compromise and, for these cases, the mean IM score was significantly higher than for steady-state patients: 491 ± 121 ng ATP/ml vs 280 ± 126 ng ATP/ml, respectively (p < 0.001).

  • Image Result
    Hazard curves for infection or rejection risk, generated from odds ratios based on IM scores. The optimal IM score range that minimizes infection and rejection risk occurs where the hazard curves for

    Hazard curves for infection or rejection risk, generated from odds ratios based on IM scores. The optimal IM score range that minimizes infection and rejection risk occurs where the hazard curves for infection and rejection risk cross (black arrow). From our data, it would appear that an IM score in the range of 370 ± 150 ng ATP/ml would keep infection and rejection risk at <5%.

  • Image Result
    Receiver operating characteristic (ROC) curve for IM in predicting subsequent infections in heart transplant recipients.

    Receiver operating characteristic (ROC) curve for IM in predicting subsequent infections in heart transplant recipients.

  • Image Result
    IM scores vs time post-transplant in steady-state patients.

    IM scores vs time post-transplant in steady-state patients.

PII: S1053-2498(09)01536-8

doi: 10.1016/j.healun.2009.12.015

The Journal of Heart and Lung Transplantation
Volume 29, Issue 5 , Pages 504-508 , May 2010

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