Immune monitoring post liver transplant

Table 2 Summary of assays for immune function monitoring

		Advantages	Disadvantages
Antigen-specific assays:	Limiting dilution aAssays, mixed lymphocyte reactions, ELISPOT	Measure individual antigen specific response	Need donor cells, Laboratory intensive
Antigen non-specific:	ImmuKnow	Available, FDA approved	Inconsistent results
	Cytokine levels/polymorphisms		Inconsistent results
	Immune competence scores	Readily available	Lack of published validation studies
	Regulatory T cells (Tregs)	Associated with rejection	Laboratory intensive. Lack of published validation studies
	Soluble CD30		Lack of association with clinical outcomes in OLTx
Identifying operational tolerant recipients:	Tregs, Gene expression, dendritic cell types, delayed type hypersensitivity	Able to identify recipients in whom immunosuppression could be withdrawn	Laboratory intensive. Only few recipients suitable

FDA: Food and drug administration; ELISPOT: Enzyme-linked immunosorbent spots; OLTx: Liver transplantation.