BACKGROUND: T-cell depletion causes a novel homeostasis in lymphocyte subsets in adult transplant recipients. Little is known about long-term changes in pediatric patients. METHODS: Twenty-one pediatric renal-transplant patients (mean age 11.8 years) were selected according to their initial postoperative immunosuppressive therapy: (1) baseline immunosuppression (BI) with cyclosporine, azathioprine, and steroids, n=11; and (2) BI plus polyclonal antibodies, n=10. Lymphocyte surface markers were measured in the mean 2.3 years after transplantation and analyzed between the patient groups and in regard to 46 age-matched healthy controls. RESULTS: The patient groups did not differ with respect to age, sex, renal function, and previous infections. Total lymphocyte counts, CD4+ T-cell numbers, and distribution of naive to memory CD4+ T cells were not different between transplant groups and controls. However, patients with postoperative T-cell depletion showed significantly lower ratios of CD4+ to CD8+ T cells, elevated CD8+ T-cell numbers, increased counts of CD8+ T cells coexpressing CD57, and higher numbers of CD8+ cells with a naive phenotype. In addition, the numbers of double-positive T cells and lymphocytes bearing both natural killer (NK) and T-cell markers were elevated in the patients with postoperative depletion. NK and B-cell counts were lower in the transplant patient groups compared with the healthy controls. CONCLUSIONS: Pediatric transplant patients show characteristic long-term changes in lymphocyte subsets after T-cell depletion. In contrast with adult patients, these perturbations are less pronounced and predominant in the CD8+ T-cell compartment.
BACKGROUND: T-cell depletion causes a novel homeostasis in lymphocyte subsets in adult transplant recipients. Little is known about long-term changes in pediatric patients. METHODS: Twenty-one pediatric renal-transplant patients (mean age 11.8 years) were selected according to their initial postoperative immunosuppressive therapy: (1) baseline immunosuppression (BI) with cyclosporine, azathioprine, and steroids, n=11; and (2) BI plus polyclonal antibodies, n=10. Lymphocyte surface markers were measured in the mean 2.3 years after transplantation and analyzed between the patient groups and in regard to 46 age-matched healthy controls. RESULTS: The patient groups did not differ with respect to age, sex, renal function, and previous infections. Total lymphocyte counts, CD4+ T-cell numbers, and distribution of naive to memory CD4+ T cells were not different between transplant groups and controls. However, patients with postoperative T-cell depletion showed significantly lower ratios of CD4+ to CD8+ T cells, elevated CD8+ T-cell numbers, increased counts of CD8+ T cells coexpressing CD57, and higher numbers of CD8+ cells with a naive phenotype. In addition, the numbers of double-positive T cells and lymphocytes bearing both natural killer (NK) and T-cell markers were elevated in the patients with postoperative depletion. NK and B-cell counts were lower in the transplant patient groups compared with the healthy controls. CONCLUSIONS: Pediatric transplant patients show characteristic long-term changes in lymphocyte subsets after T-cell depletion. In contrast with adult patients, these perturbations are less pronounced and predominant in the CD8+ T-cell compartment.
Authors: Krishna V Komanduri; Lisa S St John; Marcos de Lima; John McMannis; Steven Rosinski; Ian McNiece; Susan G Bryan; Indreshpal Kaur; Sean Martin; Eric D Wieder; Laura Worth; Laurence J N Cooper; Demetrios Petropoulos; Jeffrey J Molldrem; Richard E Champlin; Elizabeth J Shpall Journal: Blood Date: 2007-08-01 Impact factor: 22.113
Authors: S Gurkan; Y Luan; N Dhillon; S R Allam; T Montague; J S Bromberg; S Ames; S Lerner; Z Ebcioglu; V Nair; R Dinavahi; V Sehgal; P Heeger; B Schroppel; B Murphy Journal: Am J Transplant Date: 2010-09 Impact factor: 8.086
Authors: Roshan P George; Aneesh K Mehta; Sebastian D Perez; Pamela Winterberg; Jennifer Cheeseman; Brandi Johnson; Jean Kwun; Stephanie Monday; Linda Stempora; Barry Warshaw; Allan D Kirk Journal: J Am Soc Nephrol Date: 2016-07-13 Impact factor: 10.121
Authors: Wisit Cheungpasitporn; Krista L Lentine; Jane C Tan; Matthew Kaufmann; Yasar Caliskan; Suphamai Bunnapradist; Ngan N Lam; Mark Schnitzler; David A Axelrod Journal: Curr Transplant Rep Date: 2021-04-06