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CD56+CD57+ Infiltrate is a Predominant Subset of Infiltrating Natural Killer Cell in Renal Transplant Biopsies with Antibody-Mediated Rejection

H. Jung1, Y. Wee2, J. Kim2, M. Choi2, J. Choi2, H. Kwon2, J. Jung2, S. Kim3, Y. Cho4, Y. Park4, H. Go4, M. Han5, Y. Kim2, D. Han2, S. Shin2

1Department of Biomedical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of, 2Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of, 3Department of Convergence Medicine, Asan Institute for life sciences, Asan Medical Center, Seoul, Korea, Republic of, 4Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of, 5Department of Clinical Epidemiology, Asan Medical Center, Seoul, Korea, Republic of

Meeting: 2019 American Transplant Congress

Abstract number: A194

Keywords: Biopsy, Kidney transplantation, Natural killer cells, Rejection

Session Information

Session Name: Poster Session A: Kidney Chronic Antibody Mediated Rejection

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: To verify a subset of intragraft and circulating natural killer cells associated with kidney allograft rejection and fibrosis.

*Methods: Thirty-nine clinically indicated transplant biopsies performed at our center from May 2015 to July 2017 were included in this analysis. Paraffin-embedded sections of 39 renal biopsies were labeled using Opal™ multiplex kit (PerkinElmer®). We used anti-CD3, anti-CD56, anti-CD57, anti-CD49b, anti-NKG2A, and anti-KIR antibodies to define NK cells. NK cell was defined if a lymphocyte is CD3-negative, CD56-positive, and at least one of the other surface markers (CD57, CD49b, NKG2A, and KIR)-positive. In addition, we performed peripheral blood mononuclear cell (PBMC) analysis in those patients to determine NK cell subsets.

*Results: According to histopathologic reports, five patients (12.8%) had no major abnormality (NOMOA); 11 (28.2%) had T cell-mediated rejection (TCMR) only; 11 (28.2%) had pathologic features compatible with antibody-mediated rejection (ABMR) only; 9 (23.1%) had both TCMR and ABMR; and 3 (7.7%) had BKVN. Opal™ multiplex labeling revealed that the density of NK cells was very low in NOMOA group (0.17 ± 0.28 /mm2), TCMR only group (0.24 ± 0.35/mm2), and BKVN (0.05 ± 0.08/mm2). On the other hand, the density of NK cells was significantly increased in ABMR only group (1.33 ± 2.43/mm2) and both TCMR and ABMR group (1.1 ± 1.59/mm2). CD56+CD57+ infiltrate was most frequently observed subset of NK cells in every pathologic group. Kaplan-Meier survival analysis revealed that death-censored graft failure was significantly higher in recipients with infiltrating NK cells compared to those without infiltrating NK cells (Log-rank test, p=0.025). In PBMC analysis, CD49b–CD56dim NK cells were significantly decreased in the ABMR only group than the other groups, whereas CD57+NKG2C+KIR–CD56bright NK cells were significantly increased (p<0.05).

*Conclusions: In kidney transplant recipients with ABMR, CD56+CD57+ NK cell is the main subset of NK cell not only in biopsy tissue but also in circulation. Presence of infiltrating NK cells is significantly associated with death-censored graft failure.

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To cite this abstract in AMA style:

Jung H, Wee Y, Kim J, Choi M, Choi J, Kwon H, Jung J, Kim S, Cho Y, Park Y, Go H, Han M, Kim Y, Han D, Shin S. CD56+CD57+ Infiltrate is a Predominant Subset of Infiltrating Natural Killer Cell in Renal Transplant Biopsies with Antibody-Mediated Rejection [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/cd56cd57-infiltrate-is-a-predominant-subset-of-infiltrating-natural-killer-cell-in-renal-transplant-biopsies-with-antibody-mediated-rejection/. Accessed May 11, 2025.

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