Predictive tools to determine risk of infection in kidney transplant recipients

摘要: Introduction: Infection represents a major complication after kidney transplantation (KT). Therapeutic drug monitoring is essentially the only approach for adjustment of immunosuppression in current practice, with suboptimal results. The implementation immune strategies may contribute to minimizing risk adverse events attributable over-immunosuppression without compromising graft outcomes.Areas covered: present review (based on PubMed/MEDLINE searches from database inception November 2019) focused biomarkers no antigen specificity (non-pathogen-specific), including serum levels immunoglobulins and complement factors, peripheral blood lymphocyte subpopulations, soluble CD30, intracellular ATP production by stimulated CD4+ T-cells, other cell-based assays. We also summarized recent advances use replication kinetics latent viruses assess functionality T-cell immunity, focus nonpathogenic anelloviruses. Finally, composite scores reported literature are critically discussed.Expert opinion: Notable efforts have been made develop an enlarging repertoire prediction models, although most them still lack technical standardization external validation. Preventive interventions based these tools (prolongation prophylaxis, tapering immunosuppression, or immunoglobulin replacement therapy hypogammaglobulinemic patients) remain be defined, ideally context controlled trials.