Quantification of Peripheral White Blood Cell Subtypes and Delayed Graft Function after Kidney Transplantation: A Single Center Analysis

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.06.008

Jingyi Zhou , Meifang Wang , Hao Deng , Jianghua Chen

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引用次数: 0

Abstract

Background

Delayed graft function (DGF) is a critical complication following donation after circulatory death (DCD) kidney transplantation, with immunological factors contributing to its pathogenesis. This study aimed to assess whether early quantification of peripheral white blood cell (WBC) subtypes predicts DGF onset and outcomes.

Methods

In this single-center retrospective analysis, 217 DCD kidney transplant recipients (from January 2022 to December 2023) were included. Peripheral WBC subtypes (CD45+, CD3+, CD4+, CD8+, CD16+CD56+, and CD19+) were quantified via flow cytometry on postoperative day 1. Statistical analyses included logistic regression and receiver operating characteristic (ROC) curve evaluation.

Results

Among the recipients, 16.13% (35/217) developed DGF. The patients with DGF demonstrated higher serum creatinine (SCr) at discharge (235.04 ± 130.44 vs 141.90 ± 81.88 μmol/L, P < .001) and 1-year follow-up (145.76 ± 101.57 vs 108.07 ± 36.93 μmol/L, P < .001), with increased graft loss (7.4% vs 0.5%, P = .047). A lower helper T cell (CD3+CD4+) ratio predicted DGF onset (area under the curve [AUC] = 0.893, P = .001). Subgroup analysis of patients with DGF linked elevated cytotoxic T cell (CD3+CD8+) ratios to poor outcomes (SCr > 150 μmol/L/proteinuria at 1 year; AUC = 0.846, P = 0.023). Induction therapy modified these associations: Basiliximab preserved subtype differences, while antithymocyte globulin (ATG) abolished them.

Conclusions

Early postoperative quantification of WBC subtypes, particularly helper and cytotoxic T cells, offers prognostic value for DGF and its outcomes. These findings highlight the utility of routine immunological monitoring in guiding clinical management. Further studies are needed to unravel the underlying mechanisms and therapeutic implications.

查看原文本刊更多论文

肾移植后外周血白细胞亚型和延迟移植功能的定量分析：单中心分析。

背景：移植物功能延迟（DGF）是循环性死亡（DCD）肾移植术后捐赠后的一个重要并发症，其发病机制与免疫因素有关。本研究旨在评估早期外周血白细胞（WBC）亚型的定量是否能预测DGF的发病和结局。方法：在这项单中心回顾性分析中，纳入了217名DCD肾移植受者（2022年1月至2023年12月）。术后第1天通过流式细胞术定量外周血白细胞亚型（CD45+、CD3+、CD4+、CD8+、CD16+、CD56+和CD19+）。统计分析包括logistic回归和受试者工作特征（ROC）曲线评价。结果：受者中发生DGF的占16.13%（35/217）。DGF患者出院时血清肌酐（SCr）升高（235.04±130.44 vs 141.90±81.88 μmol/L, P < 0.001），随访1年（145.76±101.57 vs 108.07±36.93 μmol/L, P < 0.001），移植物损失增加（7.4% vs 0.5%, P = 0.047）。较低的辅助T细胞（CD3+CD4+）比值预示DGF的发生（曲线下面积[AUC] = 0.893, P = .001）。DGF患者细胞毒性T细胞（CD3+CD8+）比值升高与不良预后（1年SCr为150 μmol/L/蛋白尿）相关的亚组分析；Auc = 0.846, p = 0.023)。诱导治疗改变了这些关联：Basiliximab保留了亚型差异，而抗胸腺细胞球蛋白（ATG）消除了它们。结论：术后早期量化WBC亚型，特别是辅助T细胞和细胞毒性T细胞，对DGF及其结果具有预后价值。这些发现强调了常规免疫监测在指导临床管理中的作用。需要进一步的研究来揭示潜在的机制和治疗意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.