The particularities of T-lymphocytes levels after the induction immunosuppressive therapy with stem cells in kidney transplant recipients

Abstract

Induction immunosuppressive therapy is used to prevent early kidney transplant rejection and has a positive effect on the kidney transplantation long-term results, but the chronic rejection remains the main cause of transplanted organs function failure in the late post-transplantation period. Previous studies showe positive effects of stem cells therapy in kidney transplantation - lower ischemic-reperfusion injury and improvement of the  organs and tissues functional state.

Аim - to assess the dynamics of Т-lymphocytes after kidney transplantation with stem cells complex induction immunosuppressive therapy .

Materials and methods. The study group included 15 adult kidney transplant recipients who underwent first kidney allotransplantation from a living related donor with  intravenous administration of (2-3)×10⁶/kg of body weight human umbilical cord blood stem cells in 2020-2023 along with standard immunosuppressive therapy. The comparison group consisted of 30 corresponding recipients who received standard immunosuppressive therapy. The immune status of the recipients was assessed based on the results of immunophenotyping of peripheral blood lymphocytes, which are involved in the work of transplantation immunity.

Results. In the study group we saw more pronounced decrease in the level of CD45+ lymphocytes, CD3+19- T-lymphocytes compared to the comparison group. During the first month after transplantation we saw significant decrease of the I-reg level in both groups, after which the indicators approached to the control group, but did not reach it. In the study group, significantly higher rates of T-reg cell recovery were observed from the 14^th day of observation.

Conclusions. The introduction of cord blood stem cells to recipients before kidney transplantation inhibits alloactivation of the immune system to donor antigens and contributes to the creation of a protolerogenic environment in the recipient's body, which allows to predict the long-term kidney transplant function of  in the future.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of the patients was obtained for the research.

The authors declare no conflict of interest.