Tapering immunosuppression in recipients of living donor kidney transplants

We have previously suggested that the in vitro donor-specific cytotoxic T-lymphocyte precursor (CTLp) assay can guide us to identify patients in which the immunosuppressive load can be tapered. In a clinical trial we had observed that a low (

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2004-07, Vol.19 (suppl-4), p.iv61-iv63
Main Authors: Weimar, Willem, Rischen-Vos, Jacqueline, de Kuiper, Petronella, Smak Gregoor, Peter J. H., IJzermans, Jan N. M., van Besouw, Nicole M., Baan, Carla C., van der Mast, Barbara J.
Format: Article
Language:English
Subjects:
Cells, Cultured
cytotoxic T lymphocytes
Down-Regulation - physiology
Humans
immunosuppression
Immunosuppressive Agents - administration & dosage
kidney transplantation
Kidney Transplantation - immunology
Kidney Transplantation - methods
Living Donors
Prospective Studies
T-Lymphocytes, Cytotoxic - immunology
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cited_by cdi_FETCH-LOGICAL-c360t-7bc807b9fd92f1af7e7ae2f153fb3d7ec5e5aa0a8d83c698576cee87350dc03b3
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container_end_page iv63
container_issue suppl-4
container_start_page iv61
container_title Nephrology, dialysis, transplantation
container_volume 19
creator Weimar, Willem
Rischen-Vos, Jacqueline
de Kuiper, Petronella
Smak Gregoor, Peter J. H.
IJzermans, Jan N. M.
van Besouw, Nicole M.
Baan, Carla C.
van der Mast, Barbara J.
description We have previously suggested that the in vitro donor-specific cytotoxic T-lymphocyte precursor (CTLp) assay can guide us to identify patients in which the immunosuppressive load can be tapered. In a clinical trial we had observed that a low (
doi_str_mv 10.1093/ndt/gfh1044
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H. ; IJzermans, Jan N. M. ; van Besouw, Nicole M. ; Baan, Carla C. ; van der Mast, Barbara J.</creator><creatorcontrib>Weimar, Willem ; Rischen-Vos, Jacqueline ; de Kuiper, Petronella ; Smak Gregoor, Peter J. H. ; IJzermans, Jan N. M. ; van Besouw, Nicole M. ; Baan, Carla C. ; van der Mast, Barbara J.</creatorcontrib><description>We have previously suggested that the in vitro donor-specific cytotoxic T-lymphocyte precursor (CTLp) assay can guide us to identify patients in which the immunosuppressive load can be tapered. In a clinical trial we had observed that a low (&lt;10/106 PBMC) frequency of these CTLp was predictive for an uneventful rejection-free clinical course in patients that were converted from calcineurin inhibitors to mycophenolate mofetil or azathiopine. In the present prospective study in 81 stable kidney transplant recipients, already converted from calcineurin inhibitors, we measured CTLp frequencies and reduced the immunosuppressive load on a routine basis when CTLp were &lt;10/106 PBMC. Donor-specific cytotoxicity could not be measured in 50/81 patients, while their reactivity against third-party lymphocytes was not impaired. These 50 patients were tapered in their immunosuppression. Only in one patient, who had stopped all his medication, was a rejection episode diagnosed. 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source Oxford Journals Online
subjects Cells, Cultured
cytotoxic T lymphocytes
Down-Regulation - physiology
Humans
immunosuppression
Immunosuppressive Agents - administration & dosage
kidney transplantation
Kidney Transplantation - immunology
Kidney Transplantation - methods
Living Donors
Prospective Studies
T-Lymphocytes, Cytotoxic - immunology
title Tapering immunosuppression in recipients of living donor kidney transplants
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