Monitoring CD3(+) T Cells in Kidney Transplantation and Immunosuppression Adequacy.

Background: Monitoring CD3(+) T-cell counts in kidney transplant recipients can provide valuable insights into immunosuppressive therapy effectiveness. This study aimed to evaluate the use of CD3(+) T-cell levels as biomarkers for immunosuppression adequacy and to assess their predictive value for acute rejection post-transplantation.

Methods: A retrospective review was conducted involving 130 kidney transplant recipients who received induction therapy with antithymocyte globulin (ATG). CD3(+) T-cell percentages and absolute counts were measured using flow cytometry on postoperative day 5. Immunosuppression was maintained with tacrolimus, initiated upon clinical indicators of graft function recovery.

Results: Among monitored patients, the median CD3(+) T-cell percentage was 48%, and median absolute count was 0.14 × 10⁹/L. Acute rejection occurred in 9.9% of recipients. Higher CD3(+) T-cell values significantly correlated with acute rejection (64.0% vs 47.5%, p = .011; absolute count 0.28 vs 0.13 × 10⁹/L, p = .032). ROC analysis identified optimal predictive thresholds: 54% for CD3(+) percentage (sensitivity 85.7%, specificity 73.4%) and 0.21 × 10⁹/L for absolute count (sensitivity 85.7%, specificity 75.0%).

Conclusions: CD3(+) T-cell monitoring effectively guides individualized immunosuppressive strategies, significantly predicting acute rejection risks and optimizing graft outcomes.