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Chapter 138 : Evaluation of the Cellular Immune Response in Transplantation

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Abstract:

Mixed leukocyte culture (MLC) is perhaps the most widely used of cellular assays. MLC has been used clinically for donor selection, predominantly for bone marrow transplantation. In contrast to MLC, which measures a bulk response, limiting dilution assay (LDA) is a quantitative tool. contains the thymine kinase enzyme, which interferes with nucleic and amino acid metabolism and subsequently with DNA replication in the contaminated cell culture. In solid-organ transplantation, the histological analysis of allograft biopsies remains the "gold standard" for diagnosing rejection. Since the ultimate goal is the early detection of activated cells infiltrating the allograft and not in vitro priming, it also deals with methods that minimize the possibility of priming against the donor antigens in vitro. Several of the assays outlined in this chapter are being implemented in the clinical laboratory. Researchers compared helper and cytotoxic antirecipient T-cell frequencies in recipients who had received unrelated-donor bone marrow. They found that the helper T lymphocytes (HTLp) and cytotoxic T lymphocytes (CTLp) assays provided similar predictive information for outcome. The HTLp method is more rapid and less labor-intensive and, thus, may be more useful for donor selection in unrelated-donor bone marrow transplantation. A recent multicenter study evaluated the Cylex ImmuKnow assay for the measurement of immune response in immunosuppressed transplant recipients. The long-term goals of using the cellular assays described in this chapter are to assess accurately the changing immuno-logical statuses of transplant recipients, predict long-term graft outcome, and provide the immune response information needed to individualize immunosuppression therapy.

Citation: Reinsmoen N, Zeevi A. 2006. Evaluation of the Cellular Immune Response in Transplantation, p 1228-1243. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch138

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Citation: Reinsmoen N, Zeevi A. 2006. Evaluation of the Cellular Immune Response in Transplantation, p 1228-1243. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch138
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References

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Tables

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TABLE 1

Interpretation of PHA-stimulated sample results

Citation: Reinsmoen N, Zeevi A. 2006. Evaluation of the Cellular Immune Response in Transplantation, p 1228-1243. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch138
Generic image for table
TABLE 2

Distribution of results of the Cylex immune cell function assay

Citation: Reinsmoen N, Zeevi A. 2006. Evaluation of the Cellular Immune Response in Transplantation, p 1228-1243. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch138

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