Renal allograft surveillance with allospecific T-cytotoxic memory cells

Vinayak S. Rohan*, Karim M. Soliman, Ahmad Alqassieh, Duaa Alkhader, Neha Patel, Satish N. Nadig

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Allo-antigen-specific T-cytotoxic memory cells (TcM) which express CD40 ligand (CD154) in overnight lymphocyte co-culture are strongly associated with acute cellular rejection (ACR) seen in “for cause” biopsies for renal allograft dysfunction. Specifically, when the likelihood of rejection is increased, donor-specific allospecific TcM exceed those induced by HLA-non-identical third-party cell by 1.15-fold or greater. Methods: The performance of allospecific TcM was evaluated retrospectively in primary renal transplant recipients (RTR) at routine clinical visits, cross-sectionally at presentation for biopsies, and serially. Performance metrics were sensitivity, specificity, positive and negative predictive values (PPV and NPV). Results: Twenty-two primary RTR, median age 45 years (range 19–72) were tested with allospecific CD154 + TcM. Samples were obtained at the mean ± SD time interval of 806 ± 239 days after kidney transplantation. Six of 22 patients experienced biopsy proven T- Cell Mediated Rejection (TCMR). A seventh showed antibody mediated rejection (ABMR). Of these seven patients six demonstrated increased likelihood of rejection with allospecific TcM (sensitivity 83%). Ten of these 15 patients with no rejection had a negative test (specificity 67%). False positive tests were seen in five patients. Six out of 11 patients with positive tests had ACR/ABMR with a PPV of 54%, while 10 out of 11 patients with negative tests were non-rejecters with a NPV of 91%. Conclusion: Allospecific T-cytotoxic memory cells distinguished primary RTR with quiescent allografts from those with dysfunction. With serial surveillance measures, this test system may facilitate decisions to manage immunosuppression in RTR.

Original languageEnglish (US)
Pages (from-to)1152-1156
Number of pages5
JournalRenal Failure
Issue number1
StatePublished - Nov 2020
Externally publishedYes


  • Kidney transplantation
  • T- cytotoxic Memory cells
  • immune monitoring
  • rejection

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nephrology


Dive into the research topics of 'Renal allograft surveillance with allospecific T-cytotoxic memory cells'. Together they form a unique fingerprint.

Cite this