A Very Low Thymus Function Identifies Patients with Substantial Increased Risk for Long-term Mortality After Kidney Transplantation

Overview

Journal Immun Ageing

Publisher Biomed Central

Specialty Geriatrics

Date 2020 Feb 22

PMID 32082402

Citations 10

Authors

Michiel G H Betjes

Anton W Langerak

Mariska Klepper

Nicolle H R Litjens

Affiliations

Soon will be listed here.

Abstract

Background: End-stage renal disease is associated with premature ageing of the T cell immune system but inter-individual variation is substantial. The hypothesis was tested that advanced immunological T cell ageing assessed by peripheral T cell differentiation increases the long-term mortality risk after renal transplantation.

Results: Circulating T cells of 211 recipients of a kidney from a living donor were analyzed before and in the first year after transplantation. The number of CD31-positive naive T cells (as a marker for recent thymic emigrants) and the differentiation status of the memory T cells was assessed. Thirty recipients died during follow-up of at least 5 years. Absolute numbers of naive CD4 (living:258 cells/μl vs. deceased:101 cells/μl, < 0.001) and naive CD8 T cells (living:97 cells/μl vs. deceased:37 cells/μl, p < 0.001) were significantly lower in the deceased group prior to transplantation. In a multivariate proportional hazard analysis the number of naive CD4 T cells remained associated with all-cause mortality (HR 0.98, CI 0.98-0.99, < 0.001). The low number of naive T cells in the deceased patient group was primarily caused by a decrease in recent thymic emigrants (i.e. less CD31 naive T cells) indicating a lowered thymus function. In addition, the physiological age-related compensatory increase in CD31 naïve T cells was not observed. Within the first year after transplantation, the number and characteristics of naive T cells remained stable.

Conclusions: A severe reduction in circulating naïve T cells because of a decrease in recent thymic emigrants is highly associated with all-cause mortality after renal transplantation.

Citing Articles

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