Introduction:Steroids are a mainstay of immunosuppression after kidney transplant (KT). The infiltration into the graft of active T cells following KT depends on the expression of chemokines and their interaction with their T-cell receptors. However, the natural history of there expression in patients who undergo steroid withdrawal after KT is unknown.

Material and methods:In a clinical trial (NCT02284464) 176 KT patients with low immunological risk were recruited to randomly receive either conventional therapy: steroids, TAC and MMF (A) vs steroid withdrawal at post-KT month 3 (B). We compared the evolution of CCR4highCD4+ and CXCR3highCD4+ subpopulations in graft blood (GB) drawn by fine needle aspiration puncture determined by flow cytometry in patients after steroid withdrawal at post-KT month 3 vs patients who continue with conventional therapy. Measurements were made at 3 (baseline) and 6 months post-KT in GB and peripheral blood (PB).

Results:So far, 68 patients have been randomized, with no significant baseline clinical or demographic differences. The first analysis (month 3) in the patients who had completed 6 months follow-up (A: n=13; B: n=15) showed a significant increase in the CCR4highCD4 subpopulations in GB vs PB in both groups. However, at month 6 a significant increase in GB vs PB was only seen in Group A. There were no significant differences in the CXCR3highCD4+ subpopulation at month 3 or 6 between GB and PB.

Conclusion:This results could suggest a possible effect of steroids, favoring recruitment of CCR4highCD4+ cells into the renal graft.

CITATION INFORMATION: Alonso-Titos J, Ruiz-Esteban P, Palma E, Caballero A, Sola E, Cabello M, Vazquez T, Duarte A, Jironda C, Hernandez D. Evolution of CCR4highCD4+ Subpopulations in Renal Graft Blood After Steroid Withdrawal: A Prospective, Randomized, Controlled Study in Parallel Groups. Preliminary Results. Am J Transplant. 2017;17 (suppl 3).

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