Pre-transplant donor-specific Interferon-gamma-producing cells and acute rejection of the kidney allograft
Abstract
Background: Our retrospective study included a cohort of 47 patients who underwent living donor kidney transplantation. The pre-transplant frequencies of donor-specific Interferon-gamma (IFN-gamma) producing cells were defined using enzyme-linked immunosorbent spot (ELISpot) assay and correlated with incidence of acute cellular (ACR), antibody-mediated rejection (AMR) and kidney graft survival up to one year after transplantation.
Results: We found a statistically significant correlation between the frequencies of IFN-gamma-producing cells and the number of mismatches in HLA antigens between patients and their respective donors - for Class I - A and B (r = 0399, p <0.01) and for Class land Class II antigens - A, B and DR Cr = 0.409,p <0.01). No significant relationship was observed between the numbers of IFN-gamma-secreting cells and incidence of acute rejection (neither ACR, nor AMR).
However, there was a trend of elevated frequencies of IFN-gamma-producing cells in patients who developed ACR or AMR in comparison with kidney recipients free of rejection (91 82 and 114 75 vs. 72 70/5 x 10(4) peripheral blood mononuclear cells respectively). Patients with concurrent acute cellular and antibody-mediated rejection had also higher numbers of IFN-y-producing memory/effector cells compared to patients with cellular rejection only.
Conclusion: Pre-transplant determination of the numbers of IFN-y-producing donor-specific memory cells using the ELISpot technique may provide clinically relevant results when evaluating the risk of development of acute cellular and antibody-mediated rejection. These frequencies are influenced by the degree of HLA mismatching between patients and their respective kidney donors.