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A quantitative assessment model of T‐cell immune function for predicting risks of infection and rejection during the early stage after liver transplantation
Authors:Rui‐dong Li  Zhen Sun  Jia‐yong Dong  Hao Yin  Wen‐yuan Guo  Zhi‐ren Fu  Zheng‐xin Wang
Institution:1. Department of Organ Transplantation, Changzheng Hospital, Second Military Medical University, , Shanghai, China;2. Department of Laboratory Diagnotics, Changzheng Hospital, Second Military Medical University, , Shanghai, China
Abstract:Although more and more clinical studies indicated that ImmuKnow assay could efficiently assess the immune status of recipients, it still has the challenge to predict the occurrence of clinical adverse events. This study aimed to establish a quantitative assessment model, which could more efficiently predict immune function of T lymphocytes after liver transplantation based on three indexes: CD4+ T lymphocyte count (C), CD4+/CD8+ ratio (R), and ImmuKnow adenosine triphosphate (ATP) value (A). We selected 194 recipients and measured the A, C, and R index every week, then obtained the Fisher linear discriminant functions by SPSS 16.0. Next, we divided the recipients into three groups: infection, stable, and rejection groups according to clinical status. After calculating, the discriminant function, 0.012A + 0.019C + 1.322R (simplified into T = 2A + 3C + 200R), was selected to represent the T‐cell‐mediated immune function. Based on the model, the optimal cutoff T values for infection and rejection were 1415 (sensitivity = 80%, specificity = 79.9%,AUC = 92.3%) and 1939.5 (sensitivity = 93.9%, specificity = 77.6%, AUC = 88.6%), relatively (p < 0.001). In conclusion, this model may be a more feasible way to evaluate the cellular immune function status in liver transplantation recipients.
Keywords:immune function  liver transplantation  quantitative assessment model  T lymphocytes
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