Date: Saturday, June 11, 2016
Session Name: Poster Session A: Kidney: Acute Cellular Rejection
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background: End-stage renal disease patients have a dysfunctional, prematurely aged peripheral T-cell system. Here we hypothesized that the degree of premature T-cell ageing before kidney transplantation predicts the risk for early acute allograft rejection (EAR).
Methods: 222 living donor kidney transplant recipients were prospectively analyzed. EAR was defined as biopsy proven acute allograft rejection within 3 months after kidney transplantation. The differentiation status of circulating T cells, the relative telomere length and the number of recent thymic emigrants (RTE; defined as CD31+ naive T cells) were determined as T-cell ageing parameters.
Results: Of the 222 patients analyzed, 30 (14%) developed an EAR. The donor age and the historical panel reactive antibody score were significantly higher (p=0.024 and p=0.039 respectively) and the number of related donor kidney transplantation was significantly lower (p=0.018) in the EAR group. EAR-patients showed lower CD4+CD28null T-cell numbers (p<0.01) and the same trend was observed for CD8+CD28null T-cell numbers (p=0.08). No differences regarding the other ageing parameters were found. A multivariate Cox regression analysis showed that higher CD4+CD28null T-cell numbers was associated with a lower risk for EAR (HR: 0.65, p=0.028). A Kaplan-Meier analysis showed that patients with high numbers of CD4+CD28null T-cells (>36.67 cells/[micro]l) had a significantly higher EAR free survival than patients with intermediate (4.33–36.67 cells/[micro]l) and low (<4.33 cells/[micro]l) numbers of these cells (p=0.008 and p=0.009 respectively). In vitro, a significant lower percentage of alloreactive T cells was observed within CD28null T cells (p<0.001).
Conclusion: Immunological ageing-related expansion of highly differentiated CD28null T cells is associated with a lower risk for EAR.
CITATION INFORMATION: Dedeoglu B, Meijers R, Klepper M, Hesselink D, Baan C, Litjens N, Betjes M. Immunological Ageing-Related Expansion of Highly Differentiated CD4+CD28null T Cells Is Associated with a Lower Risk for Early Acute Rejection After Renal Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Dedeoglu B, Meijers R, Klepper M, Hesselink D, Baan C, Litjens N, Betjes M. Immunological Ageing-Related Expansion of Highly Differentiated CD4+CD28null T Cells Is Associated with a Lower Risk for Early Acute Rejection After Renal Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). http://atcmeetingabstracts.com/abstract/immunological-ageing-related-expansion-of-highly-differentiated-cd4cd28null-t-cells-is-associated-with-a-lower-risk-for-early-acute-rejection-after-renal-transplantation/. Accessed September 21, 2017.
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