Is the determination of the soluble interleukin-2 receptor after application of interleukin-2 receptor antibodies still appropriate for immunological monitoring after renal transplantation?

INTRODUCTION

The use of monoclonal antibodies against the alpha-chain of the membrane-bound interleukin-2 receptor (IL-2Ralpha) as immune suppressants causes characteristic changes in the levels of soluble interleukin-2 receptor (sIL-2R) in serum and urine.

METHODS

38 kidney transplant patients were included in this study. 28 of them received an induction therapy with the IL-2R antibody basiliximax (Simulect) in addition to standard immunosuppression, 10 patients constituted the control group.

RESULTS

Time courses of sIL-2R levels of Simulect patients with and without complications after transplantation have been compared. It turned out that of a total of 18 cases with complications 15 cases could be identified by their elevated sIL-2R levels, which corresponds to a sensitivity of 83%.

CONCLUSION

Acute rejection, CMV infection, extrarenal bacterial infection and pyelonephritis in the transplant all cause a significant increase of the sIL-2R level even after application of Simulect.