CD8 T Cell Biomarkers Improves the Capacities of the Kidney Transplant Failure Score for the Long-Term Prognostic of Kidney Graft Failures

N. Degauque,^1,2 M. Yap,¹ G. Tilly,^1,3 P. Guerrif,² M. Giral,² S. Brouard,^1,2 Y. Foucher.^2,3

¹INSERM UMR1064, Nantes, France
²CHU de Nantes, Nantes, France
³University of Nantes, Nantes, France.

Meeting: 2015 American Transplant Congress

Abstract number: C274

Keywords: Area-under-curve (AUC), Graft survival, Kidney transplantation, Prognosis

Session Information

Session Name: Poster Session C: Translational Biomarkers and Immune Monitoring

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Background. Kidney transplantation is acknowledged as the treatment of choice for patients in end-stage renal disease compared to dialysis. We hypothesized that the efficiency of the transplantation can still be improved by adaptating the follow-up of kidney transplant recipients (KTR) according to their risk to return in dialysis. The Kidney Transplant Failure Score (KTFS) has been developed to address such a stratification of KTR according to their susceptibility of graft failure. The KTFS is a scoring system based on 8 clinical parameters collected during the first year post transplantation. The aim of the present study was to assess if the prognostic capacities of the KTFS can be improved thanks to the implementation of immunological markers.

Method. 161 adult recipients of organs from heart-beating deceased donors with a functional transplant on the first anniversary of their transplantation were prospectively recruited. Multi-color flow cytometry was performed to characterize the expression of CD45RA, CCR7, CD27, CD28, T-Bet, CD57, GZM-b, PERF, CD127 by CD8 T cells at 1 year post-transplantation. Graft survival was computed regarding the time between the transplantation and the return to dialysis of the patient (death censored).

Results. Among the 161 KTR, 14 returned to dialysis at the end of the follow-up and 7 died. The mean follow-up time was 4.4 years post-transplantation. The 6-year graft survival was 84.7% (Kaplan-Meier estimator, 95% CI 77.3 – 92.9%). Among the 6 biomarkers significantly associated with the graft survival independently to the KTFS (Cox regression, p<0.05), high values of TEMRA, CD27-CD28- and GZMB+PERFD48- were associated with an increase in the risk of graft failure. The Area Under the time-dependent ROC Curve (AUC) of the KTFS can be improved from 0.64 (95% CI 0.48 – 0.80) to 0.76 (95% CI 0.62 – 0.90) with the inclusion of biomarkers. Finally, the increase of 0.12 of the AUC (p=0.03) results in a better classification of 26.1% of the patients (Net Reclassification Index, p=0.0312).

Conclusion. Our study provides evidences of the benefit of the implementation of CD8 immunological markers to the KTFS to improve its prognostic capacities. Moreover, our study strengthen the need to monitor modification in CD8 T cell compartment and raises the need of innovative therapy targeting this compartment.

To cite this abstract in AMA style:

Degauque N, Yap M, Tilly G, Guerrif P, Giral M, Brouard S, Foucher Y. CD8 T Cell Biomarkers Improves the Capacities of the Kidney Transplant Failure Score for the Long-Term Prognostic of Kidney Graft Failures [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/cd8-t-cell-biomarkers-improves-the-capacities-of-the-kidney-transplant-failure-score-for-the-long-term-prognostic-of-kidney-graft-failures/. Accessed November 21, 2024.

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