Should IFN-γ, IL-17 and IL-2 be considered predictive biomarkers of acute rejection in liver and kidney transplant? Results of a multicentric study

•Multicenter study to evaluate predictive biomarkers of AR in transplantation•Intracellular IFN-γ+ and IL-2+ T-cells and IL17 may identify recipients at risk of AR.•Pre and 1st week post-transplantation algorithms for AR risk prediction

Acute rejection (AR) remains a major challenge in organ transplantation, and there is a need for predictive biomarkers. In the present multicenter study, we prospectively examined a series of biomarkers in liver and kidney recipients. Intracellular expression of IFN-γ, IL-17 and IL-2 and IL-17 soluble production were evaluated both pre-transplantation and post-transplantation (1st and 2nd week, 1st, 2nd and 3rd month). 142 transplant patients (63 liver/79 kidney) were included in the study. Twenty-eight recipients (14 liver/14 kidney) developed AR. Pre- and post-transplantation intracellular expression of %IFN-γ+ in CD4+CD69+ and in CD8+CD69+ and soluble IL17 identified liver and kidney transplant patients at high risk of AR. Pre-transplantation, %IL-2+ in CD8+CD69+ also identified kidney patients at high risk. We constructed pre- and post-transplantation risk prediction models, based on a composite panel of biomarkers, which could provide the basis for future studies and will be a useful tool for the selection and adjustment of immunosuppressive treatments.