Evidence map›Paper›PMID 33323473›Full record

Trial reportJournal of the American Society of Nephrology : JASN2021

Steering Transplant Immunosuppression by Measuring Virus-Specific T Cell Levels: The Randomized, Controlled IVIST Trial.

Thurid Ahlenstiel-Grunow, Xiaofei Liu, Raphael Schild, Jun Oh, Christina Taylan, Lutz T Weber, Hagen Staude, Murielle Verboom, Christoph Schröder, Ruxandra Sabau and 2 more

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
3.5field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 31 citations in OpenAlex.

  1. Trial
  2. Article
  3. Adoptive T-cell therapy for virus-associated diseases.Clinical microbiology reviews · 2025
    Review
  4. Article
  5. Immune Monitoring Goes Viral - Torque Teno Virus for Immunologic Risk Stratification After Kidney Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Review
  6. Article
  7. Review
  8. Review
  9. Article
  10. Review
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 1 country.

Thurid Ahlenstiel-GrunowDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Xiaofei LiuInstitute of Biostatistics, Hannover Medical School, Hannover, Germany.
Raphael SchildDepartment of Pediatric Nephrology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Jun OhDepartment of Pediatric Nephrology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Christina TaylanDepartment of Pediatric Nephrology, Children's and Adolescents' University Hospital, University of Cologne, Cologne, Germany.
Lutz T WeberDepartment of Pediatric Nephrology, Children's and Adolescents' University Hospital, University of Cologne, Cologne, Germany.
Hagen StaudeDepartment of Pediatric Nephrology, University Children's Hospital, University Hospital of Rostock, Rostock, Germany.
Murielle VerboomInstitute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany.
Christoph SchröderDepartment of Pharmacovigilance, Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
Ruxandra SabauDepartment of Pharmacovigilance, Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
Anika GroßhennigInstitute of Biostatistics, Hannover Medical School, Hannover, Germany.
Lars PapeDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Medizinische Hochschule Hannover · DEUniversity Medical Center Hamburg-Eppendorf · DEUniversity of Duisburg-Essen · DEUniversity Hospital Cologne · DEUniversity of Cologne · DEUniversity of Rostock · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPharmacokinetic monitoring is insufficient to estimate the intensity of immunosuppression after transplantation. Virus-specific T cells correlate with both virus-specific and general cellular immune defense. Additional steering of immunosuppressive therapy by virus-specific T cell levels might optimize dosing of immunosuppressants.

methodsIn a multicenter, randomized, controlled trial, we randomized 64 pediatric kidney recipients to a control group with trough-level monitoring of immunosuppressants or to an intervention group with additional steering of immunosuppressive therapy by levels of virus-specific T cells (quantified by cytokine flow cytometry). Both groups received immunosuppression with cyclosporin A and everolimus in the same target range of trough levels. Primary end point was eGFR 2 years after transplantation.

resultsIn the primary analysis, we detected no difference in eGFR for the intervention and control groups 2 years after transplantation, although baseline eGFR 1 month after transplantation was lower in the intervention group versus the control group. Compared with controls, patients in the intervention group received significantly lower daily doses of everolimus and nonsignificantly lower doses of cyclosporin A, resulting in significantly lower trough levels of everolimus (3.5 versus 4.5

conclusionsSteering immunosuppressive therapy by virus-specific T cell levels in addition to pharmacokinetic monitoring seems safe, results in a similar eGFR, and personalizes immunosuppressive therapy by lowering exposure to immunosuppressive drugs, likely resulting in lower drug costs. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: IVIST trial, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2009-012436-32 and ISRCTN89806912.

Indexed as

Kidney TransplantationAdolescentCD4 Lymphocyte CountChildChild, PreschoolCyclosporineDrug Administration ScheduleDrug MonitoringEverolimusFemaleGraft RejectionHumansImmunosuppressive AgentsInfantKidney Failure, ChronicMaleCyclosporineEverolimusImmunosuppressive Agentsimmunosuppressionkidney transplantationlymphocytespediatric kidney transplantation

Identifiers

PMID33323473
PMCPMC8054884
OpenAlexW3112820342

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.