This journal is
indexed in Scopus
Year 2021 Vol. 29 No 3
TRAUMATOLOGY AND ORTHOPEDICS
S.V. ZYBLEVA, S.L. ZYBLEV
IMMUNOLOGICAL PREDICTORS OF RENAL GRAFT REJECTION IN THE EARLY POSTOPERATIVE PERIOD
Republican Research Center for Radiation Medicine and Human Ecology, Gomel,
The Republic of Belarus
Objective. To determine the immunological predictors of renal graft rejection in the early postoperative period.
Methods. Three groups were formed out of the 197 renal graft recipients. The group PGF (n=101) was made up of patients with satisfactory primary graft function. The group PGD (n = 82) included patients with primary graft dysfunction without episodes of rejection. The group RGR (n=14) consisted of patients with primary dysfunction and renal graft rejection. On the 7th day after transplantation the early kidney graft function was assessed on the basis of serum creatinine levels. When the serum creatinine value was lower than 300 μmol/L the function was considered to be primary, at a creatinine concentration was equal to or higher than 300 μmol/L, as well as in the case of need for maintenance dialysis on the first week after transplantation, the state was classified as the renal graft dysfunction. In the early postoperative period, the number of LIN-HLA-DR+ dendritic cells with the LIN- HLA-DR+CD11c+CD123- and LIN-HLA-DR+CD11c-CD123+ phenotypes in the fluid from the drainage installed to the kidney graft during surgery was determined. Predictive characteristics of the mDC and pDC levels in the drainage fluid were determined to predict renal graft rejection, and diagnostic capability of this indicator were identified.
Results. It has been revealed that renal graft rejection is characterized by a significant growth of the total number of dendritic cells in the drainage fluid, mainly due to myeloid ones. Predictive characteristics were determined by the level of myeloid and plasmacytoid dendritic cells in the drainage fluid. The cut-off point of the level of myeloid dendritic cells was determined at the level of 60.32%, and for plasmacytoid dendritic cells it corresponded to 39.68%.
Conclusion. With the level of myeloid dendritic cells in the drainage fluid greater or equal 60.32%, and plasmacytoid cells lower or equal 39.68%, renal graft rejection is predicted with a sensitivity of 99% and 93%, respectively, and a specificity of 89% and 91%, respectively.
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246000, Republic of Belarus,
Gomel, Ilyich Str., 290,
Republican Research Center
for Radiation Medicine and Human Ecology
tel. mobile: +375 44 547-69-85,
Zybleva Svetlana V.
Zybleva Svetlana V., PhD, Immunologist, Scientific Secretary, Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
Zyblev Sergey L., PhD, Associate Professor, Surgeon of the Surgery Unit (Transplantation, Reconstructive and Endocrine Surgery), Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.