Background: End-stage renal disease (ESRD) patients have a prematurely aged T-cell system, which may contribute to the uremia-associated immune deficiency. In this study we tested whether characteristics of premature T-cell ageing, assessed prior to and within the first year after renal transplantation (RT), are associated with the risk for infections after RT.

Methods: We prospectively studied 188 living donor RT-recipients during their first year after RT. The peripheral T cells were analyzed before, and 3 and 6 months after RT, for the content of recent thymic emigrants (RTE), the relative telomere length (RTL) and differentiation status. T-cell differentiation status was assessed by immunophenotyping, RTL was determined as a measure for proliferative history and RTE were identified by the presence of CD31⁺ naive T cells. These parameters were related to the occurrence of opportunistic infections (OI) and serious infections (SI).

Results: Of the 188 RT-recipients, 84 (45%) developed an infection during the first year after RT and were defined as the infection group. Within this group, 50 (60%) patients developed an OI and 53 (63%) developed an SI. The majority of the infections (85%) occurred within the first 6 months, and within this period the majority (66%) of the infections occurred within the first 3 months. T-cell ageing parameters assessed prior to RT were not associated with the risk for infection during the first 6 months. The CD4⁺ and CD8⁺ memory T-cells showed a significant decrease within the first 3 months after RT in both groups (p<0.001). The CD4⁺ memory T cells increased between T=3 and T=6, only reaching statistical significance for the infection group (p=0.015). The number of CD8⁺ memory T cells increased significantly in both groups (p<0.001), but reached baseline levels only in the infection group. In the infection group the percentage of CD8⁺CD28null T cells increased significantly (p=0.024) between T=3 and T=6, tending to be higher than at baseline (p=0.061). The RTL of the CD8⁺ T-cell population only increased significantly in the infection group between T=0 and T=3 (p=0.018). The observed differences in the post-RT dynamics were a consequence of an infectious episode.

Conclusion: Parameters of uremia-associated premature ageing of peripheral T-cells do not predict post-transplant infections.

CITATION INFORMATION: Dedeoglu B, Meijers R, Klepper M, Hesselink D, Baan C, Litjens N, Betjes M. Parameters of Uremia-Associated Premature Ageing of Peripheral T Cells Do Not Predict Infectious Complications After Renal Transplantation. Am J Transplant. 2016;16 (suppl 3).

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