Immune profiling and cancer post transplantation

作     者：Christopher Martin Hope Patrick Toby H Coates Robert Peter Carroll 

作者机构：Centre for Clinical and Experimental TransplantationCentral Northern Adelaide Renal and Transplantation ServicesAdelaide SA 5000Australia Department of Medicinethe University of AdelaideAdelaide SA 5000Australia Central Northern Adelaide Renal and Transplant ServicesRenal LabIMVS buildingRoyal Adelaide HospitalAdelaide SA 5000Australia 

出 版 物：《World Journal of Nephrology》 (世界肾病学杂志（英文版）)

年 卷 期：2015年第4卷第1期

页      面：41-56页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Immune-profiling Immunosuppression Kidney Malignancy Transplantation 

摘      要：Half of all long-term( 10 year) australian kidney transplant recipients(KTR) will develop squamous cell carcinoma(SCC) or solid organ cancer(SOC), making cancer the leading cause of death with a functioning graft. At least 30% of KTR with a history of SCC or SOC will develop a subsequent SCC orSOC lesion. Pharmacological immunosuppression is a major contributor of the increased risk of cancer for KTR, with the cancer lesions themselves further adding to systemic immunosuppression and could explain, in part, these phenomena. Immune profiling includes; measuring immunosuppressive drug levels and pharmacokinetics, enumerating leucocytes and leucocyte subsets as well as testing leucocyte function in either an antigen specific or non-specific manner. Outputs can vary from assay to assay according to methods used. In this review we define the rationale behind post-transplant immune monitoring assays and focus on assays that associate and/or have the ability to predict cancer and rejection in the KTR. We find that immune monitoring can identify those KTR of developing multiple SCC lesions and provide evidence they may benefit from pharmacological immunosuppressive drug dose reductions. In these KTR risk of rejection needs to be assessed to determine if reduction of immunosuppression will not harm the graft.