Effect of Immunosuppression on Target Blood Immune Cells Within 1 Year After Lung Transplantation: Influence of Age on T Lymphocytes
Benjamin Coiffard, Matthieu Pelardy, Anderson D. Loundou, Corine Nicolino-Brunet, Pascal Alexandre Thomas, Laurent Papazian, Françoise Dignat-George, Martine Reynaud-Gaubert
Department of Respiratory Medicine and Lung Transplantation, Hosital Nord, Marseille, France
Ann Transplant 2018; 23:11-24
Lymphocytes are targeted by immunosuppressive therapy in solid organ transplantation and they influence allograft outcome.
MATERIAL AND METHODS: Peripheral blood lymphocyte subsets (PBLS) determined by flow cytometry during the first year post-transplant from patients who underwent a first lung transplantation in a French University Hospital between December 2011 and July 2013 were retrospectively analyzed according to recipient characteristics and allograft outcome.
RESULTS: Fifty-seven recipients were enrolled and 890 PBLS were collected. T lymphocytes and NK cells were rapidly decreased, below normal range, from the first postoperative days. B cells decreased more gradually, remaining within normal range, with the lowest level reached after day 100. In multivariate analysis, greater T lymphopenia was found in older recipients (–414 [–709 to –119] cells/µL, p=0.007). According to the outcome, multivariate analysis evidenced lower levels of lymphocytes when bacterial and viral infection occurred (–177 [–310 to –44] cells/µL, p=0.009 and (–601 [–984 to –218] cells/µL, p=0.002, respectively), higher CD8+ T lymphocytes with BOS (+324 [+94 to +553] cells/µL, p=0.006), and higher leukocytes with restrictive allograft syndrome (+3770 [+418 to +7122] cells/µL, p=0.028).
CONCLUSIONS: Aging is associated in our cohort with more severe T lymphopenia after induction therapy for lung transplantation. The analysis of leukocytes and PBLS is associated with specific profile according to the allograft outcome.
Keywords: Aging, Graft Rejection, Lung Transplantation, Lymphocyte Subsets, Opportunistic Infections