Premature ageing of T cells In end-stage renal disease patients does not predict infectious complications after renal trans­plan­tation


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B. Dedeoglu, R.W.J. Meijers, M. Klepper, D.A. Hesselink, C.C. Baan, N.H.R. Litjens, M.G.H. Betjes

Chair(s): dr. Hennie G. Otten, medisch immunoloog, UMC Utrecht & dr. Laura B. Bungener, medisch immunoloog, UMC Groningen

Thursday 10 march 2016

9:30 - 9:40h at Zaal 1 & 2

Categories: Parallelsessie (basaal)

Parallel session: Parallelsessie VII - Basaal immunologie

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Background:
ESRD patients have a prematurely aged T-cell system, which may contribute to the uremia-associated immune deficiency. In this study we tested the hypothesis that the 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 of transplantation. The peripheral T cells were analyzed before, and 3 and 6 months after transplantation, for the content of recent thymic emigrants (RTE), the relative telomere length (RTL) and differentiation status. We assessed T-cell differentiation status by immunophenotyping, RTL was determined as a measure for proliferative history and RTE were identified by the expression of CD31 within the naïve T cell pool. 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 after RT, and within this period the majority (66%) of the infections occurred within the first 3 months after RT. 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-cell compartments 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 amount 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, almost resulting in a larger value 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), and remained similar thereafter. The observed differences in the post-RT dynamics in several T cell subsets and RTL was a consequence of an infectious episode.

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