Kidney Transplantation and Cellular Immunity Dynamics: Immune Cell Alterations and Association with Clinical and Laboratory Parameters
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Flow Cytometry
2.3. Statistics
3. Results
3.1. Patient Characteristics
3.2. Changes in Immune Cell Phenotype during Follow-Up
3.3. Effect of Clinical and Laboratory Parameters in Adaptive Immunity during Follow-Up
3.3.1. Role of Peri-Transplantation Circumstances
3.3.2. The Role of Renal Function Outcomes after Renal Transplantation
3.3.3. Role of Lymphocyte Subsets in Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Recipients’ Characteristics | N = 112 |
---|---|
Male/Female, N (%) | 77/35 (68.8/31.3%) |
Age (yrs) | 48.5 (39–57) |
Primary kidney disease, N (%) | |
Nephrosclerosis/hypertension | 6 (5.3%) |
Primary glomerulopathies | 26 (23%) |
Diabetes mellitus | 6 (5.3%) |
Urinary tract infections/stones | 6 (5.3%) |
Reflux nephropathy | 13 (11.6%) |
Polycystic kidney disease | 24 (21.4%) |
Other | 16 (14.2%) |
Unknown | 15 (13.3%) |
Dialysis Data, N (%) | |
HD/PD | 89/11 (79.5/9.8%) |
Dialysis vintage (months) | 87 (34–127) |
Preemptive transplantation | 12 (10.7%) |
Retransplantation | 10 (8.9%) |
Transplantation | |
Cold ischemia time (hours) | 17 (0–19) |
Delayed graft function, Ν (%) | 20 (17.9%) |
Rejection, N (%) | 7 (6.3%) |
Infections, N (%), | 13 (11.6%) |
Induction with basiliximab | 106 (94.6%) |
Treatment with anti-thymocyte globulin, N (%) | 17 (15.2%) |
Donors’ characteristics | |
Male/Female | 58/54 (51.8/48.2%) |
Age (years) | 53 (14–76) |
Marginal donor, Ν (%) | 6 (5.4%) |
Donor cause of death | |
Anoxia | 4 (3.6%) |
CVA | 60 (53.6%) |
Trauma | 19 (17.0%) |
Donor relationship, N (%) | |
CD/LD | 83/29 (74.1/25.9%) |
T Cell Subsets | T0 | T3 | T6 | T12 | p |
---|---|---|---|---|---|
T cells (cells/μL) | 1200 (1000–1600) | 1600 (1200–2300) | 1700 (1300–2300) | 1700 (1400–2300) | <0.001 |
T cells (%) | 18.3 (14.8–24) | 21.8 (16.8–31.5) | 24 (20.2–31.6) | 25.1 (20.3–31.6) | <0.001 |
CD4+ (cells/μL) | 483 (384–707) | 769 (526–1142) | 807 (574–1116) | 819 (600–1107) | <0.001 |
CD4+ (%) | 41.4 (36.1–48.7) | 47.4 (40.5–53.4) | 46.5 (40.3–53.4) | 46.8 (38.3–53.9) | <0.001 |
CD8+ (cells/μL) | 310 (215–416) | 437 (291–633) | 499 (341–648) | 534 (387–743) | <0.001 |
CD8+ (%) | 24.6 (20.4–30.1) | 26.9 (21.7–32) | 28.3 (24.1–34) | 29.1 (24–38) | <0.001 |
NK cells (cells/μL) | 210 (152–307) | 151 (86–245) | 150 (105–270) | 150 (106–299) | <0.001 |
NK cells (%) | 17.6 (11.8–25.2) | 8.9 (5.4–14.9) | 9.2 (6.1–16.5) | 8.7 (6–15.2) | <0.001 |
Tregs (cells/μL) | 24 (15–33) | 29 (18–51) | 33 (24–48) | 33 (21–48) | <0.001 |
Tregs (%) | 2.2 (1.4–3.1) | 2.2 (1.5–3) | 2.1 (1.5–2.9) | 2.1 (1.5–2.8) | 0.28 |
Univariate Regression | Multivariate Regression | ||||||||
---|---|---|---|---|---|---|---|---|---|
95% Confidence Interval | 95% Confidence Interval | ||||||||
T cells | β | R2 | p | lower | upper | β | p | lower | upper |
Age | −0.41 | 0.17 | <0.001 | −29.8 | −11.7 | −0.32 | 0.001 | −26.5 | −6.6 |
DV | −0.29 | 0.08 | 0.002 | −6.2 | −1.4 | −0.06 | 0.6 | −3.9 | 2.3 |
CIT | −0.31 | 0.09 | 0.001 | −38.2 | −9.8 | −0.14 | 0.23 | −29.5 | 7.1 |
CD4+ T cells | |||||||||
Age | −0.42 | 0.18 | <0.001 | −16.7 | −6.8 | −0.33 | 0.001 | −14.8 | −3.9 |
DV | −0.31 | 0.09 | 0.001 | −3.5 | −0.8 | −0.08 | 0.5 | −2.2 | 1.2 |
CIT | −0.32 | 0.1 | 0.001 | −21.2 | −5.6 | −0.13 | 0.25 | −15.8 | 4.2 |
CD8+ T cells | |||||||||
Age | −0.21 | 0.04 | 0.03 | −9.1 | −0.5 | −0.15 | 0.14 | −8.09 | 1.1 |
DV | −0.16 | 0.03 | 0.08 | −2 | 0.13 | ||||
CIT | −0.22 | 0.05 | 0.02 | −14.01 | −1.02 | −0.16 | 0.12 | −12.5 | 1.4 |
eGFR ≤ 50 | eGFR > 50 | |
---|---|---|
T cells T0 | 1200 (1000–1600) | 1200 (1000–1600) |
T cells T12 | 1600 (1200–1885) | 1900 (1500–2400) |
p | 0.01 | <0.001 |
CD4+ T cells T0 | 522 (364–827) | 481 (386–704) |
CD4+ T cells T12 | 628 (458–893) | 857 (616–1122) |
p | 0.12 | <0.001 |
CD8+ T cells T0 | 308 (182–387) | 314 (227–421) |
CD8+ T cells T12 | 467 (367–672) | 542 (389–767) |
p | <0.001 | <0.001 |
Natural Killers T0 | 225 (152–307) | 148 (103–332) |
Natural Killers T12 | 195 (107–297) | 198 (145–319) |
p | 0.14 | 0.04 |
Regulatory T cells T0 | 26 (14–38) | 23 (15–32) |
Regulatory T cells T12 | 26 (20–42) | 34 (23–49) |
p | 0.44 | <0.001 |
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Vagiotas, L.; Lioulios, G.; Panteli, M.; Ouranos, K.; Xochelli, A.; Kasimatis, E.; Nikolaidou, V.; Samali, M.; Daoudaki, M.; Katsanos, G.; et al. Kidney Transplantation and Cellular Immunity Dynamics: Immune Cell Alterations and Association with Clinical and Laboratory Parameters. J. Clin. Med. 2024, 13, 5093. https://doi.org/10.3390/jcm13175093
Vagiotas L, Lioulios G, Panteli M, Ouranos K, Xochelli A, Kasimatis E, Nikolaidou V, Samali M, Daoudaki M, Katsanos G, et al. Kidney Transplantation and Cellular Immunity Dynamics: Immune Cell Alterations and Association with Clinical and Laboratory Parameters. Journal of Clinical Medicine. 2024; 13(17):5093. https://doi.org/10.3390/jcm13175093
Chicago/Turabian StyleVagiotas, Lampros, Georgios Lioulios, Manolis Panteli, Konstantinos Ouranos, Aliki Xochelli, Efstratios Kasimatis, Vasiliki Nikolaidou, Margarita Samali, Maria Daoudaki, Georgios Katsanos, and et al. 2024. "Kidney Transplantation and Cellular Immunity Dynamics: Immune Cell Alterations and Association with Clinical and Laboratory Parameters" Journal of Clinical Medicine 13, no. 17: 5093. https://doi.org/10.3390/jcm13175093