Immunologic induction therapy affects immune status of recipients after kidney transplantation

Li Jian; Xu Ya-hong; Guo Yu; Ma Xiao-ping; Lu Yi; Li Yang-bo; Jia Zhi-gang; Zhao Qi-hua; Luo Shun-wen; Chen Ping

doi:10.3969/j.issn.2095-4344.2014.36.007

Abstract：BACKGROUND:At present, biological agent-involved immunologic induction therapy gradual y became a key component in immunosuppression therapy of kidney transplantation. It can effectively prevent acute rejection and avoid the appearance of complications. OBJECTIVE:To evaluate the effect of different biological agents on immune state and functional status of transplanted kidney in immunologic induction therapy. METHODS:Clinical data of 110 recipients with kidney transplantation were retrospectively analyzed. In accordance with the conditions of immunologic induction therapy, recipients in the monoclonal antibody group (n=35) received basiliximab. Recipients in the polyclonal antibody group (n=43) underwent rabbit anti-human antithymocyteglobulin. Recipients in the control group (n=32) did not receive immunologic induction therapy. Absolute value of lymphocytes and the number of CD4+T lymphocyte subsets in peripheral blood were comparatively analyzed among three groups at 1, 4 and 12 weeks after kidney transplantation. Functional status of the transplanted kidney and complications of infection were evaluated at 12 weeks after transplantation.RESULTS AND CONCLUSION:The incidence of acute rejection was lower in the monoclonal antibody group and polyclonal antibody group than in the control group (P<0.05). The incidence of infectious complications was higher in the polyclonal antibody group than in the monoclonal antibody group and control group (P<0.05). The absolute value of lymphocytes was lower in the monoclonal antibody group and polyclonal antibody group at 1, 4 and 12 weeks after transplantation than in the control group (P<0.05). The number of CD4+T lymphocyte subsets in peripheral blood was lower in the polyclonal antibody group than in the monoclonal antibody group and control group at 1, 4 and 12 weeks after transplantation (P<0.05). These results suggested that biological agents participate in immunologic induction therapy of kidney transplantation, can effectively suppress the functional status of activated T lymphocytes, and decrease the occurrence of early acute rejection of the transplanted kidney. However, the incidence of infectious complications was higher after the use of rabbit anti-human antithymocyteglobulin.