To study CD4+ T lymphocytes cell function assay using the Immuknow in infections after renal transplantation

Objective To evaluate the value of ATP content of CD4+ T lymphocytes in the diagnosis of infection and its correlation with drug concentrations in renal transplant recipients.Methods 45 renal transplant recipients were reviewed from May 2010 to October 2011.There were 33males and 12 females,aged from 21 to 58 years old.The recipients were divided into non-infection group (n =34) and infection group (n =11) according to their clinical manifestation.11 cases of infection were diagnosed by the chest X-ray,CT imaging manifestations and etiological examination,among them 5 cases were pulmonary infection,4 cases were upper respiratory infection,1 case was urinary tract infection and 1 case was perineal abscess.23 healthy volunteers were enrolled as the control group.They were detected ATP content of CD4+T lymphocytes by Immuknow method.Thetrough concentrations of the FK506 and CsA were detected by microparticle enzyme immunoassay and fluorescence polarization immunoassay,respectively.The hs-CRP concentration was detected by immunoturbidimetry.Results The ATP content of CD4+ T lymphocytes of the control group,non infection group and the infection group were (295±74) μg/L,(35± 189) μg/L and (212± 155) μg/L respectively.The levels of ATP of infection group were obviously lower than the control group and non-infection group.There were statistically differences (P ＜0.05).24 recipients were followed up dynamicly.There were 4 cases whose ATP value was lower than the postoperative average levels in 5 infection recipients.The hs-CRP concentration of infection group were (12.4±4.8) mg/L,obviously higher than the non infection group's (3.3 ± 4.7) mg/L and the control group' s (0.5 ± 0.5) mg/L.There were statistically differences (P＜0.05).The ATP content of CD4+ T lymphocytes were no significant associated with drug trough concentrations (P＞0.05).Conclusions Low ATP level after renal transplantation is a risk factor for infection recipients.Immuknow cell function assay can make up for the inadequacy of the drug concentration monitoring,reduce the risk of infection,and guide clinical immunosuppressive adjustment. Key words: Kidney transplantation;  Infection;  CD4+ T-lymphocyte;  Adenosine triphosphate