Document Type: Original Article

Authors

Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Monitoring of phenotypic characteristics of T-lymphocytes in peripheral blood is commonly performed to give the clinical parameters in the management of kidney transplant recipients.  
Objective:
To predict rejection in renal transplantation by immune parameters.
Methods: 16 non-diabetic kidney transplant candidates (4 females and 12 males, age = 20-65 yr, first time transplant) were selected. The transplanted patients were divided into two groups based on the rejection during 3 weeks post transplant: group I (n = 9) without rejection and group II (n = 7) with a rejection episode. Immune parameters including lymphocytes subpopulations (by flowcytometry) and immunoglobulin classes (IgM, IgG, IgA and IgE by nephlometric assay) before and 45 days after transplantation were determined.  
Results:
The results of this investigation showed that the level of immunoglobulin IgG, IgM, IgA and IgE decreased post transplantation due to immunosuppressive drugs. CD3, CD4, CD8 T cells count, CD56 NK cells count and CD20 B cells count pre- and post-transplantation did not show any significant differences. The amount of IgE (220   vs. 462 IU/ml), CD3 (62% vs. 69.7%) and CD4 (35% vs. 41.3%) cells increased in group II during rejection episode pre-transplantation. In addition, IgA increased pretransplantation in group I those without rejection episode in comparison with group II with a rejection episode. Forty five days post transplantation IgA (209   vs. 152 mg/dl), IgG (1009 vs. 703 mg/dl) and CD20 (15%   vs. 10%) increased in group I patients.
Conclusion:
It is suggestive that pre-transplantation increases IgE, CD3 and CD4 are predictive of acute rejection.

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