engleski

Immune status monitored in kidney transplantation. Is it predictable?

Background: Judgment of dosage combined immunosuppressive regimen, and its effectiveness for patient and graft short- and long-term survival is still one of the most important problems in kidney transplantation.Methods: The serial monitoring of a number of immune cells in circulation such as T and B lymphocyte, NK cells, CD4+ and CD8+ T lymphocytes, activated (CD25+) and cytotoxic (CD56+) T cell, was introduced to monitor the patient’s recovery. Twenty six patients (18 male and 8 female) who underwent renal transplantation at Merkur University Hospital between January 2006 and December 2007, were included in the study. In 12 patients acute rejection was justified by PHDanalysis of renal biopsy. Absolute and percentage cell’s value measurements were done on EPICS XL flow cytometer using the highly standardized protocols for cell quantification on single platform. Internal and external quality control UKNEQAS Immune Monitoring programme results fulfilled the recommended target limits.Results: During the first two months upon transplantation similar behaviour pattern of lymphocyte subset cell count occurred in sequential measurements for the patients with acute rejection, as in the group without. Decreasing lymphocyte compartment was seen in the first measurement compared to the pre- transplantation value for both groups, followed by rising to normal levels in the next.Conclusions: The serial measurement of immune cell’s count is useful for monitoring the patient’s recovery after surgical procedure and assures reliable monitoring of immunosuppressive therapy in kidney transplantation, although according to our results the cell count changes can’t predict graft rejection.

immunosuppressive regimen; kidney transplantation; immunosuppressive therapy

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