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Background: It was found that regulatory T cells (Tregs) importantly affect the maintenance of the kidney graft. However, Tregs are a heterogeneous population with less to more suppressive activity. The aim of this study was to determine the effects of different subsets of Tregs, as well as their ratio to effector T cells (Teff), on kidney transplantation outcomes., Methods: A total of 58 participants were enrolled in this study and divided into four groups: (i) first kidney transplant recipients (stable 1); (ii) second kidney transplant recipients (stable 2); (iii) transplant recipients with acute rejection (AR); and (iv) healthy control subjects. By using flow cytometer, the frequencies of CD4 + CD25 ++ CD45RA - Foxp3 hi activated Tregs (aTregs), CD4 + CD25 + CD45RA + Foxp3 lo resting Tregs (rTregs), CD4 + CD25 + CD45RA - Foxp3 lo non-suppressive T cells, CD4 + CD25 + Foxp3 - cells Teff, and total Tregs were analyzed in all subjects., Results: The frequency of aTregs (as well as the ratio of aTregs/Tregs) was significantly lower in the AR patients than the other three groups. In contrast to AR patients, stables 1 and 2 had a higher aTreg/Treg ratio than those in the control group. Although patients with AR had a significantly lower total Tregs than the other three groups, the balance of total Tregs and Teff was similar between patients with and without AR., Conclusion: Patients with AR had poorer immunoregulatory properties than those with normal graft functioning, as well as those in the control group. These reduced immunoregulatory properties in patients with AR could lead to graft rejection., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The half-life of transplanted kidneys is <10 years. Acute or chronic rejections have a negative impact on transplant outcome. Therefore, achieving to allograft tolerance for improving long-term transplant outcome is a desirable goal of transplantation field. In contrast, there are evidence that distinct immunological characteristics lead to tolerance in some transplant recipients. In contrast, the main reason for allograft loss is immunological responses. Various immune cells including T cells, B cells, dendritic cells, macrophages, natural killer, and myeloid-derived suppressor cells damage graft tissue and, thereby, graft loss happens. Therefore, being armed with the comprehensive knowledge about either preimmunological or postimmunological characteristics of renal transplant patients may help us to achieve an operational tolerance. In the present study, we are going to review and discuss immunological characteristics of renal transplant recipients with rejection and compare them with tolerant subjects., (© 2018 Wiley Periodicals, Inc.)

Long-term immunosuppressive therapy after renal transplantation increases the risk of developing malignancy. The aim of this study was to determine the demographic parameters and immunosupression protocol in kidney transplant recipients with and without malignancy. This case-control study was undertaken on 12 renal transplant recipients with malignancy and 48 with-out malignancy at The Shahid Beheshti Kidney Transplantation Center in Babol (north of Iran). Data including age, gender, number of anti-rejection therapies and immunosupression regimen were recorded and analyzed with SPSS and Mann-Whitney Fisher's exact t-test. P value < 0.05 was considered significant. The prevalence of malignancy in 380 renal allograft recipients was 3.15% during six years of follow-up. The malignancies noted after renal transplantation included: Kaposi's sarcoma (n = 5), lymphoma (n = 3), cutaneous basal cell carcinoma (n = 2), cutaneous squamous cell carcinoma (n = 1) and brain tumor (n = 1). Age of patients at the time of trans-plantation, duration of immunosupression treatment and number of anti-rejection therapies were not significantly different in patients with and without malignancy (P > 0.05). Males were signi-ficantly more affected with malignancy compared to females (P < 0.05). Our study shows that there was no significant correlation between age at transplantation, duration of immunosupression treatment and number of anti-rejection therapies and occurrence of post-renal transplantation malignancy; however, the prevalence of malignancy was significantly higher in male patients. The most common malignancy seen was Kaposi's sarcoma followed by lymphoma.