Pre-Transplant Peripheral Lymphocyte Subsets Predict Pneumonia After Renal Transplantation

BACKGROUND Kidney transplantation (KTx) has been considered as the most effective therapeutic method for end-stage renal disease. Immune monitoring of peripheral lymphocyte subsets (PLS) reflects the real immune status and has been used for diagnosis of pneumonia after KTx. We aimed to investigate the association between pre-transplant PLS and pneumonia in renal allograft recipients. MATERIAL AND METHODS A total of 152 patients receive donation after citizen's death (DCD) kidney allografts in our center between January 2018 and December 2019. Among them, 114 patients were enrolled in our study based on inclusion and exclusion criteria. During the first-year follow-up after KTx, 32 recipients developed pneumonia, and the other 82 recipients did not (stable group). The pre-clinical information and PLS (including the percentages and absolute numbers (Ab No.) of peripheral T, B, and NK cells, as well as CD4/CD8 ratio) results in these 2 groups were calculated by the Mann-Whitney test and receiver operating curve (ROC) analysis. Univariate and multivariate logistic regression analyses were employed to identify risk factors. RESULTS Compared to the stable group, the Ab No. of CD3+, CD8+, and CD4+ T cells, as well as B cells and NK cells, were notably reduced in the pneumonia patients. The area under the curve (AUC) of CD3+ T cell Ab No. was 0.7022. Multivariate analysis demonstrated that pre-transplant B cell Ab No. was the independent risk factor for pneumonia progression after KTx (OR=0.353, P=0.037). CONCLUSIONS Pre-transplant Ab No. of PLS were closely related to pneumonia after KTx. Monitoring pre-transplant PLS could provide more timely and effective prevention and therapy for post-operative pneumonia after KTx.