Novosti
Khirurgii
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Year 2019 Vol. 27 No 4

TRANSPLANTOLOGY

DOI: https://dx.doi.org/10.18484/2305-0047.2019.4.409   |  

A.V. NOSIK 1, S.V. KOROTKOV 1, 2, V.V. SMOLNIKOVA 2, V.YU. HRYNEVICH 2, M.V. DMITRIEVA 3, A.A. DOLGOLIKOVA 2, I.I. PIKIRENIA 1, 2, S.I. KRIVENKO 2, O.V. KALACHIK 1, 2, A.E. SHCHERBA 1, 2, O.O. RUMMO 1, 2

VALUE OF ASSESSMENT OF LYMPHOCYTES SUBPOPULATIONS NUMBERS IN PERIPHERAL BLOOD FOR DIAGNOSIS OF CELLULAR REJECTION AFTER KIDNEY TRANSPLANTION

Belarusian Medical Academy of Postgraduate Education 1,
Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology 2,
City Clinical Pathologoanatomic Bureau 3, Minsk
The Republic of Belarus

Objective. To study the possibility of assessing the number of peripheral blood lymphocyte subpopulations as biomarkers of late kidney transplant rejection.
Methods. This is a report of retrospective single center case-control study involving 44 patients who underwent kidney transplantation. The first group (AR) includes patients with chronic graft dysfunction, caused by biopsy proven late cellular rejection (22 patients). The second group (STA) contains recipients, who havent any dysfunction in the post-transplant period (22 patients). Flow cytometry of the peripheral blood cells was performed to evaluate the immune status of recipients.
Results. As a result of the research, accurate differences of absolute account of effector memory T cellwere determined, which accounted for in REJ group 0.147 (0.115-0.260)×109 cell/l, and in STA group 0.106 (0.067-0.136)×109 cell/l (=0.0167). Relative and absolute accounts of myeloid dendritic cells were different as well: 0.65 (0.36-0.73) vs 1.05 (0.67-1.4) % and 0.039 (0.028-0.056) vs 0.063 (0.049-0.076)×109 cell/l, respectively (=0.0009, =0.003). Number of plasmacytoid dendritic cells was also different between study groups: absolute account 0.0038 (0.0021-0.0054) vs 0.005 (0.0035-0.007)×109 cell/l (=0.0414), and relative account 0.055 (0.04-0.085) vs 0.09 (0.05-0.12) % (=0.0197).
The evaluation of diagnostic characteristic of revealed biomarkers was performed by using ROC-analysis. The area under ROC-curve (AUC) for absolute number of effector CD4+ memory T cells accounted for 0.711 (95 % CI: 0.55-0.84), =0.007. AUC for relative and absolute number of myeloid dendritic cells was assessed respectively as 0.784 (95% CI: 0.63-0.89) and 0.758 (95 % CI: 0.6-0.87), at significance values respectively =0.0001 and =0.0004. For relative and absolute number of plasmacytoid dendritic cells AUC accounted for respectively to 0.7 (95% CI: 0.55-0.83) and 0.68 (95% CI: 0.51-0.8), at significance values =0.01 and =0.0357.
Conclusions. The received data showed that blood level of dendritic cells and the level of effector helper T memory cells can be reasonably considered as diagnostic markers of kidney transplant cellular rejection in late period after operation.

Keywords: kidney transplantation, kidney allograft, immune monitoring, biomarkers, rejection
p. 409-420 of the original issue
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Address for correspondence:
220013, The Republic of Belarus,
Minsk, P.Brovko Str., 3, build. 3,
Belarusian Medical Academy of Postgraduate Education,
Transplantology Department.
Tel. +375 (33) 312-86-24,
e-mail: doctornosik@gmail.com,
Alexander V. Nosik
Information about the authors:
Nosik Alexander V., Assistant of the Transplantology Department, Belarusian Medical Academy of Postgraduate Education, Surgeon of the Transplantation Unit, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-3500-0866
Korotkov Sergey V., PhD, Associate Professor of the Transplantology Department, Belarusian Medical Academy of Postgraduate Education, Head of the Transplantation Unit (Liver Transplantation and Hepatobiliary Surgery), Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-8536-6911
Smolnikova Viktoryia V., Senior Researcher, the Research Department, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-5947-8285
Hrynevich Viktoryia Yu., Physician of Laboratory Diagnostics, Clinical-Diagnostic Laboratory, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-4505-4884
Krivenko Svetlana I., MD, Associate Professor, Deputy Directorfor Science, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-6813-4465
Dmitrieva Margarita V., Pathologist, City Clinical Pathologoanatomic Bureau, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-2958-9424
Pikirenia Ivan I., PhD, Associate Professor, Head of the Transplantology Department, Belarusian Medical Academy of Postgraduate Education, Surgeon of the Surgery Unit, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-8907-4601
Dolgolikova Anna A., PhD, Nephrologist of the Nephrology Unit, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-3576-2235
Kalachik Oleg V., MD, Associate Professor of the Transplantology Department, Belarusian Medical Academy of Postgraduate Education, Deputy Director for the Medical Affairs, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Head of the Republican Center for Nephrology, Renal Replacement Therapy and Kidney Transplantation,Minsk, Republic of Belarus.
https://orcid.org/0000-0002-8993-0292
Shcherba Aliaksei E., MD, Associate Professor of the Transplantology Department, Belarusian Medical Academy of Postgraduate Education, Deputy Director for Surgery, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-0569-6150
Rummo Oleg O., MD, Professor, Corresponding Member of the National Academy of Sciences of Belarus, Professor of the Transplantology Department, Belarusian Medical Academy of Postgraduate Education, Director, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-7023-4767
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