Exploring the effects of plasma exchange (PE) on T lymphocytes and natural killer cells after kidney transplantation
10.3760/cma.j.cn114452-20240628-00336
- VernacularTitle:血浆置换对肾移植术后T淋巴细胞和自然杀伤细胞的影响
- Author:
Xue LIU
1
;
Shuya WANG
1
;
Qiankun YANG
1
Author Information
1. 郑州大学第一附属医院输血科，郑州 450052
- Publication Type:Journal Article
- Keywords:
Plasma exchange;
Kidney transplantation;
TLymphocytes;
Natural killer cells
- From:
Chinese Journal of Laboratory Medicine
2025;48(5):634-639
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of plasma exchange (PE) on T lymphocytes and natural killer (NK) cells in patients after kidney transplantation.Methods:The study retrospectively collected clinical data from patients who underwent their first ABO-compatible kidney transplantation at the Kidney Transplantation Center of the First Affiliated Hospital of Zhengzhou University between January 1, 2021, and November 30, 2023. Based on whether the patients received PE after transplantation, they were divided into a PE group and a non-PE group. A total of 38 patients were included in the retrospective cohort study, 18 in the PE group (8 males and 10 females) and 20 in the non-PE group (11 males and 9 females), with median ages of 37.5 (19.0, 56.0) years and 40.7 (22.0, 60.0) years, respectively. The immune cell subpopulations of the two groups were analyzed and compared at three time points: before PE, after PE, and 7 to10 days post-PE (for the non-PE group, data were collected at equivalent time points). The primary focus was on the proportions and absolute counts of T cells, NK cells, and activated T cells (CD4CD25+T cells, CD8CD25+T cells, and CD8HLA-DR+T cells). A generalized estimating equation (GEE) was used for longitudinal analysis of these repeated measurements to evaluate the effects of PE on changes in these cell populations.Results:From 7 to 10 days after PE, the absolute count of CD4 T cells in the non-PE group increased from 42 (24, 152) cells/μl to 461 (309, 608) cells/μl, while in the PE group, it increased from 57 (11, 262) cells/μl to 212 (141, 576) cells/μl. According to the generalized estimating model, the difference in changes between the two groups was statistically significant ( Z=-2.9, P=0.004). For NK cell absolute counts, the non-PE group increased from 20 (16, 36) cells/μl to 43 (26, 81) cells/μl, while the PE group increased from 22 (12, 63) cells/μl to 90 (28, 142) cells/μl. The difference in changes between the two groups was also statistically significant ( Z=1.87, P=0.049). Regarding T cell activation, the proportion of CD8HLA-DR+T cells in the non-PE group decreased from 25.8% (18.4%, 45.0%) to 22.7% (15.2%, 31.6%), while in the PE group, it increased from 19.2% (8.1%, 33.2%) to 22.7% (15.2%, 31.6%). The difference in changes between the two groups was statistically significant ( Z=2.88, P=0.005). From 7 to 10 days after PE, there were significant differences in the changes of CD4CD25+T cells ( Z=2.70, P=0.009), CD8CD25+T cells ( Z=2.75, P=0.007), and CD8HLA-DR+T cells ( Z=4.04, P=0.001) between the PE group and the non-PE group. Conclusion:Plasma exchange after kidney transplantation can suppress the proliferation of CD4 T lymphocytes, increase the number of NK cells relatively, and maintain a high proportion of activated T lymphocytes.
