Immune system features in pediatric candidates for kidney transplantation

Abstract

Background. The state of the recipient’s immune system may influence significantly the results of transplantation and should be taken into account when choosing the tactics of immunosuppressive therapy. Materials and me­thods. The retrospective analysis of cytometric peripheral blood lymphocytes examination: T cells (CD3+, CD19–), T-helper cells (CD3+, CD4+), T-cytotoxic (CD3+, CD8+), T-activated (CD3+, HLA-DR+), T-NK cells (CD3+, CD16+56+), B cells (CD3–, CD19+, HLA-DR+), NK-cells (CD3–, CD16+56+) was done in 40 adult and 20 pediatric patients with end stage renal disease (ESRD) on haemodialysis the day before kidney transplantation in O.O. Shalimov National Institute of Surgery and Transplantation. Results. Higher B-lymphocytes and lower T-cytotoxic and T-activated levels were found in children with end stage renal disease compared to adult patients. There were also tendencies to decreased T-NK and NK-cell levels, as well as to increased CD4+/CD8+ ratio in pediatric patients. The state of immune system in pediatric patients with ESRD before transplantation differs from that in adults. But, taking into account the contradictory published data on this issue, we consider it necessary to continue the investigation with a mandatory analysis of parameters dynamics in posttransplant period. Conclusions. The differences of lymphocyte subsets repertoire in children before kidney transplantation should be considered when choosing optimal scheme of immunosuppressive therapy.