肾移植 , 细胞免疫功能 , 感染

Objective To investigate the feasibility of Cylex ImmuKnow assay in clinical application and its diagnostic value for the infection after renal transplantation. Methods We collected 48 renal transplant recipients. The patients were divided into two groups according to clinical status，namely，infection group（19 cases），and non-infection group（29 cases）. Sixteen healthy adults were collected as control. Triple immunosuppressive therapy postrenal transplantation consisted of prednisone，calcineurin inhibitors（tacrolimus of cyclosporin）and MMF，with anti- human T lymphocyte rabbit immunoglobulin（ATG）for the immunological induction during perioperative period as well. The adenosine triphosphate（ATP）level within the CD4+ T lymphocytes was detected through labeling the monoclonal antibody coated and immunomagnetic beads isolated CD4+ T lymphocytes using fluorescent agents after stimulation by PHA before，onset and one week's recovery after the infection. Results When infection occurred，ATP concentrations in CD4+ T cells of the kidney transplant recipients were significantly lower than those in non-infection group〔（134.20±58.24）μg/L vs.（306.32±107.62）μg/L，P＜0.05〕，and those before infection onset

〔（134.20±58.24）μg/L vs.（359.37±81.35）μg/L，P＜0.01〕. After the infection was fully defeated，the ATP concentrations in CD4+ T cells increased to the level before infection occurred. Conclusion The examination of ATP in CD4+ T cells by Cylex ImmuKnow assay could reflect the status of cellular immunity，provide reliableand objective basis for the diagnosis and treatment of infection after renal transplantation，and guide the clinicalindividualized immunosuppressive therapy.