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 α-chain of the membrane-bound interleukin-2 receptor (IL-2Rα) 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.

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