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Optimisation of Immunosuppressive Therapy by Monitoring of Immune Function in Transplant Recipients

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Summary

Immunosuppressive therapy after organ transplantation is a balance between rejection because of underimmunosuppression and infectious complications because of overimmunosuppression. In the diagnosis of graft function, clinical and laboratory parameters are complemented by the study of the functional and phenotypic characteristics of immunocompetent cells in the transplanted organ and in the peripheral blood. The objective is the identification of complications prior to functional deterioration of the transplant.

For characterisation of modifications in the transplant, conventional histology and fine needle aspiration biopsy are introduced to the clinical routine. In the acute post-transplantation phase they are useful, whereas in the late phase, especially in the diagnosis of chronic rejection, many open questions remain.

Alternatively, immune monitoring of peripheral blood, involving cytofluorometric analysis of lymphocyte and monocyte markers, may be used. It includes the detection of humoral allosensitisation before and after transplantation, the monitoring of treatment with anti-T cell antibodies, and the recognition of overimmunosuppression, infectious complications because of immunodepression, and rejection episodes. The results obtained are used to adjust the dosage of immunosuppressive agents; furthermore, the results of modification of immunosuppression can also be observed directly by the use of an immune monitoring programme.

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Authors and Affiliations

  1. Department of Surgery, Charité, Humboldt-University, Schumannstrasse 20/21, 10435, Berlin, Germany

    Utz Settmacher

  2. Department of Medical Immunology, Charité, Humboldt-University, Berlin, Germany

    Wolf Döcke & Hans-Dieter Volk

Authors
  1. Utz Settmacher
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  2. Wolf Döcke
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  3. Hans-Dieter Volk
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Settmacher, U., Döcke, W. & Volk, HD. Optimisation of Immunosuppressive Therapy by Monitoring of Immune Function in Transplant Recipients. Clin. Immunother. 3, 386–394 (1995). https://doi.org/10.1007/BF03259503

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  • DOI: https://doi.org/10.1007/BF03259503

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