engleski

PERIPHERAL BLOOD CD19+ LYMPHOCYTES PREDICT KIDNEY ALLOGRAFT INTERSTITIAL FIBROSIS AND TUBULAR ATROPHY ON 1- YEAR PROTOCOL BIOPSIES

Introduction: Noninvasive tests measuring cellular or humoral immunity may be helpful in prediction of late kidney allograft function and progression of chronic histology changes. Aim of this study was to asses whether specific subset of peripheral blood lymphocytes could predict 1-year renal function and changes in Banff ct, ci and ah scores over one year. Methods: A cohort of 46 kidney transplant patients was analyzed. Immunophenotyping of peripheral blood lymphocytes (CD4, CD8, CD127, CD25 and CD19) was done by flow cytometry at kidney transplantation. Protocol kidney biopsies were done on day 0 and at 1 year after transplantation and were scored according to the Banff 07 classification. Δci, Δct and Δah were calculated by subtracting 0 biopsy scores from 1 year chronic scores. Univariate and multiple regression analyses were done to test correlations. Results: In a univariate analysis recipient and donor age were positively correlated with 1-year Δci, Δct and Δah. The number of CD19+ and CD8+ peripheral blood cells was negatively correlated with one-year Δci, Δct and Δah. Δah was also in a positive correlation with CD4/CD8 ratio. In a multiple regression analysis Δci (b=-0, 54 ± 0.20, p=0, 007) and Δct (b=-0, 50 ± 0, 20, p=0, 018) were independently associated only with number of CD19+ lymphocytes. Δah remained significantly correlated only with value of CD4/CD8 (b=0, 50 ± 0, 17, p=0, 007). In a univariate analysis 1- year creatinine clearence was negatively correlated with recipient and donor age and positively with CD19+ and CD8+ lymphocyte counts. However, recipient and donor age were the only variables that remained significantly correlated with 1-year kidney function in multiple regression analysis. Conclusion: CD19+ cells in peripheral blood may be a useful biomarker for prediction of 1-year kidney allograft histology changes. Higher peripheral blood CD19+ cell count at kidney transplantation may be associated with slower progression of IF/TA.

kidney transplantation; CD19+ cells; chronic scores; IFTA

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