Studying some lymphocyte subpopulations in search for predictors of renal graft dysfunction

Abstract

Introduction. One of the main problems in transplantology is the detection of simple, reliable and non-invasive markers that could predict adverse immune reactions and adjust immune suppressive therapy in allograft recipients in a timely manner.
Objective. To determine the immunological criteria for the prediction of a graft dysfunction.
Material and methods. We have examined 197 recipients who underwent kidney transplantation. All of them were immunologically examined with the identification of more than 40 subpopulations of leukocytes. Allograft function was assessed on day 7 with the division of patients into two groups: with either primary or graft dysfunction. Simple and multiple logistic regressions were used to predict a graft dysfunction. Preliminary statistical analysis was performed using nonparametric statistics.
Results and discussion. A scoring system to predict the graft function has been worked out. At CD19⁺IgD⁺CD27-<72.7%, score 1 is assigned, and 0 score is given at > 72.7%. At CD3⁺CD8⁺CD69⁺>9.7% score 1 is assigned, and 0 score is given at CD3⁺CD8⁺CD69⁺<9.7%. Total score is calculated by summing up the scores. The total score = 0 predicts a primary graft function; total score >1 predicts a graft dysfunction. This scoring system has the sensitivity of 91.9%, еру specificity of 100%, еру accuracy of 94.9%, positive predictive value of 1 and negative predictive value of 0.877.
Conclusions. 1. Percentage of CD19⁺IgD⁺CD27- and CD3+CD8+CD69+ subpopulations can be used to predict a graft dysfunction. 2. At values of CD19⁺IgD⁺CD27- not exceeding 72.7% and CD3⁺CD8⁺CD69⁺ more than 9.7%, the development of a graft dysfunction can be anticipated.