Novosti
Khirurgii

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 haven’t 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 (р=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 (р=0.0009, р=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 (р=0.0414), and relative account 0.055 (0.04-0.085) vs 0.09 (0.05-0.12) % (р=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), р=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 – р=0.0001 and р=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 р=0.01 and р=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.

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