Gandolfini, IlariaCrespo, ElenaBaweja, MuktaJarque, MartaDonadei, ChiaraLuque, SergioMontero Pérez, NúriaAllesina, AnnaPerin, LauraMaggiore, UmbertoCravedi, PaoloBestard Matamoros, Oriol2019-03-192019-03-192018-07-301932-6203https://hdl.handle.net/2445/130524Donor-specific (d-sp) interferon gamma enzyme-linked immunosorbent spot (d-sp ELISPOT)and Panel of reactive T-cell (PRT) ELISPOT assays have been developed to detect alloreactive memory T (Tmem) cells in order to estimate the risk of acute rejection after kidney transplantation. Adding IL15 to the PRT assay (PRT+IL15) may uncover the presence of pathogenic alloreactive CD28-Tmem. Face-to-face comparisons of these assays have not been done yet. We performed pre-transplant d-sp ELISPOT and PRT assays (±IL15, against six B-cell lines) in 168 consecutive kidney transplant recipients and evaluated the multivariable-adjusted associations with biopsy-proven acute rejection (BPAR), de novo donor-specific antibodies (DSA), and eGFR decline over a 48-month follow-up period. D-sp ELISPOT was positive in 81 (48%) subjects, while 71 (42%) and 81 (48%) subjects displayed positive PRT and PRT+IL15, respectively.Their median [interquartile range] numerical test result was 23 [6±65], 18 [8±37], and 26 [10±45] spots/3x105 PBMCs, respectively. The number of PRT spots were weakly correlated with those of d-sp ELISPOT, but highly correlated with PRT+IL15 (rho = 0.96, P<0.001). d-sp ELISPOT, but not PRT (±IL15) was independently associated with BPAR (adjusted Odds Ratio of BPAR associated with d-sp ELISPOT positivity: 4.20 [95%CI: 1.06 to 21.73; P = 0.041]). Unlike d-sp ELISPOT, median PRT and PRT+IL15 were independently associated with higher Δ3-48month eGFR decline post-transplantation (for both assays, about -3mL/min/1.73m2 per one standard deviation unit increase in the spot number). Pre-transplant T-cell immune-monitoring using d-sp ELISPOT and PRT assays identifies kidney transplant candidates at high risk of BPAR and worse kidney allograft progression.26 p.application/pdfengcc-by (c) Gandolfini, Ilaria et al., 2018http://creativecommons.org/licenses/by/3.0/esTrasplantament renalImmunologia de la trasplantacióMalalties del ronyóKidney transplantationTransplantation immunologyKidney diseasesinfo:eu-repo/semantics/article6851662019-03-19info:eu-repo/semantics/openAccess30059561