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30 August 2023 : Original article  

[In Press] Dynamic Changes of Regulatory T Cells/CD4⁺ T Cells in Peripheral Blood of Adult Kidney Transplant Recipients: A Comparison of Pediatric and Adult Kidney Donors

Qi Xiao1ABCDEFG, Zide Chen1ABCDEF, Shitao Zhao1BCD, Kaifeng Luo1BCD, Fuping Cao1BF, Zexu Zhang1BF, Jia Liu1BF, Jiansheng Xiao1ACDEFG

DOI: 10.12659/AOT.940604

Ann Transplant In Press; DOI: 10.12659/AOT.940604  

Available online: 2023-08-30, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


Inducing transplantation tolerance and monitoring the recipient’s immune status to improve allograft survival remains the main goal for kidney transplantation (KTx).
A total of 53 renal transplantation patients and 20 healthy individuals were assigned to the post-transplantation and healthy groups, respectively; 10 recipients with stable renal function for 2 years after kidney transplantation were assigned to Group C. Eleven kidney transplantation recipients were hospitalized due to lung infection. Flow cytometry was used to measure levels of Tregs/CD4⁺ T cells.
The Tregs/CD4⁺ T cells ratio reached homeostasis 6 months after KTx, with no significant difference between Group D (healthy control group) and pre-surgery or Group C (2 years after KTx group). The pediatric donor group and the adult donor group reached immune homeostasis 3 months after the operation. Immune homeostasis is maintaining a balance between immune tolerance and immunogenicity. There was no significant difference in graft function between the pediatric and adult donor groups before surgery, 1 day after surgery, 1 week after surgery, 2 weeks after surgery, and 1 month after surgery; however, graft function was significantly better in the pediatric donor group compared with the adult donor group at 3 mouths (eGFR: 51.7 (40.4-66.2) vs 73.0 (55.7-90.2), P=0.008<0.05) and 6 months (eGFR: 52.2 (37.5-62.8) vs 80.5 (64.1-90.4), P<0.001) after surgery. Pediatric donor kidneys reached immune homeostasis 3 months after surgery, with better graft function at this time compared with adult donor kidneys. The proportion of Tregs/CD4⁺ T cells in recipients with a pulmonary infection after KTx was lower than in those with infection recovery.
Expanding the use of pediatric kidneys should be further explored by the transplantation community. The proportion of Tregs/CD4⁺ T cells in recipients with a pulmonary infection after KTx was lower than in those with infection recovery.

Keywords: Kidney Transplantation; T-Lymphocytes, Regulatory; Donor Selection; Respiratory Tract Infections

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358