Malignancies Contribute to Presensitization with Alloreactive T-Cells in Kidney Transplant Recipients.

T. Schachtner,^1,2 M. Stein,² P. Reinke.^1,2

¹Nephrology and Internal Intensive Care, Charite Campus Virchow Clinic, Berlin, Germany
²Berlin-Brandenburg Center for Regenerative Therapies, Charite Campus Virchow Clinic, Berlin, Germany.

Meeting: 2016 American Transplant Congress

Abstract number: 29

Keywords: Allorecognition, Kidney transplantation, Malignancy, Rejection

Session Information

Session Name: Concurrent Session: Kidney Acute Cellular Rejection: Clinical Outcomes and Pathological Characteristics

Session Type: Concurrent Session

Date: Sunday, June 12, 2016

Session Time: 2:30pm-4:00pm

Presentation Time: 2:54pm-3:06pm

Location: Ballroom C

Alloreactive T-cells have been suggested to impact allograft outcome due to a higher incidence of acute rejection in the initial period after kidney transplantation. Knowledge on risk factors for the development of preformed and de-novo activated alloreactive T-cells and their impact on patient and allograft outcomes, however, remains scarce.

Here, we analyzed clinical characteristics and outcomes of 327 kidney transplant recipients (KTRs) of a first kidney allograft transplanted at our center from 2008 to 2013.KTRs were grouped with respect to the presence of alloreactive T-cells pretransplantation. KTRs without alloreactive T-cells pretransplantation were grouped with respect to the development of alloreactive T-cells posttransplantation. Samples were collected pretransplantation, at +1, +2, and +3 months posttransplantation, and alloreactive T-cells were measured using an interferon-γ Elispot assay.

Among 327 KTRs, 107 KTRs (33%) showed detectable alloreactive T-cells pretransplantation, whereas 220 KTR (67%) didn't. Risk factors for the presence of preformed alloreactive T-cells included older age, diabetes, and prior malignancies (p<0.05). Preformed alloreactive T-cells were associated with a higher incidence of delayed graft function (p=0.017). Among 220 KTRs without alloreactive T-cells pretransplantation, 31 KTRs (14%) showed detectable alloreactive T-cells posttransplantation, whereas 189 KTR (86%) didn't. Risk factors for the development of de-novo alloreactive T-cells included younger age, female sex, and prior malignancies (p<0.05). KTRs with preformed/de-novo alloreactive T-cells showed inferior patient survival, allograft survival, and allograft function, a higher incidence of acute cellular rejections, sepsis, and posttransplant malignancies (p<0.05).

The presence of alloreactive T-cells strongly impacts patient and allograft outcomes. Treated or undetected malignancies may lead to presensitization with preformed alloreactive T-cells. Caution should be taken in KTRs with alloreactive T-cells with regards to minimizing immunosuppression.

CITATION INFORMATION: Schachtner T, Stein M, Reinke P. Malignancies Contribute to Presensitization with Alloreactive T-Cells in Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Schachtner T, Stein M, Reinke P. Malignancies Contribute to Presensitization with Alloreactive T-Cells in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/malignancies-contribute-to-presensitization-with-alloreactive-t-cells-in-kidney-transplant-recipients/. Accessed November 22, 2024.

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