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Potent early immune response after kidney transplantation in patients of the European senior transplant program.
Potent early immune response after kidney transplantation in patients of the European senior transplant program.
- Source :
-
Transplantation [Transplantation] 2009 Apr 15; Vol. 87 (7), pp. 992-1000. - Publication Year :
- 2009
-
Abstract
- Background: The increasing age of organ donors and the transplantation of older recipients have become clinical practice. Age-adapted immunosuppressive protocols considering these changes are currently not established. This study analyzed the age-dependent immune response after human kidney transplantation.<br />Methods: One hundred renal allograft recipients were prospectively evaluated from 2004 to 2005. Patients older than 65 years of the European Senior Program receiving kidneys from donors older than 65 years were compared with recipients younger than 65 years receiving kidneys from donors younger than 65 years. Age-dependent modifications of the immune response were evaluated before transplantation and 7 days and 6 months after grafting by flow cytometry analysis of lymphocyte surface markers in peripheral blood. The cytokine pattern was determined by Cytometric Bead Array, T-cell alloreactivity by enzyme-linked immunospot analysis.<br />Results: There were no differences between the groups regarding patient survival, graft survival, and function at 6 months after transplantation. Before transplantation, 7 days and 6 months thereafter recipients older than 65 years demonstrated significantly elevated numbers of memory T-cells while counts for naive T-cells were significantly reduced. Numbers of activated cytotoxic cells were elevated with increasing age before and 7 days after transplantation. T-cell alloreactivity was more pronounced in older recipients at all time points. Seven days after transplantation tumor necrosis factor-alpha (TNF-alpha) levels were significantly higher, whereas TNF-alpha and interleukin-10 (IL-10) concentrations were significantly reduced after 6 months in older recipients.<br />Conclusions: Our data demonstrate an initially pronounced immune response in elderly recipients receiving grafts from elderly donors. This observation supports the concept of a donor and recipient age-adapted immunosuppression.
- Subjects :
- Adult
Age Factors
Aged
Berlin
Female
Flow Cytometry
Germany
Glucocorticoids therapeutic use
Graft Rejection drug therapy
Graft Rejection epidemiology
Graft Survival immunology
Humans
Immunosuppressive Agents therapeutic use
Interferon-gamma blood
Interleukins blood
Male
Methylprednisolone therapeutic use
Middle Aged
Tissue Donors
Transplantation Immunology
Transplantation, Homologous
Tumor Necrosis Factor-alpha blood
Kidney Transplantation immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 87
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 19352117
- Full Text :
- https://doi.org/10.1097/TP.0b013e31819ca0d7