Ibrahim Mohamed A, El Said Heba W, Sany Dawlat H, Mostafa Afaf A
a Department of Nephrology , Ain Shams University , Cairo , Egypt ;
b Department of Clinical Pathology , Ain Shams University , Cairo , Egypt.
Ren Fail. 2016 Sep;38(8):1210-7. doi: 10.1080/0886022X.2016.1209062. Epub 2016 Jul 14.
We assessed the effect of hepatitis C seropositivity on the percentage of various T-cells in living donor renal transplant recipients (LDRTRs) and their association with intercurrent infections post renal transplantation (post-Tx).
One hundred and thirty-three matching LDRTRs [A (seronegative) (68 patients) and B (seropositive) (65 patients) by ELISA] were studied prospectively 10 days, 6 months and 12 months post-Tx for intercurrent infections, acute rejection and T-cell% by flow cytometry.
CD4(+), CD8(+), CD4/CD8 were significantly higher 10 days post-Tx in Group B compared to Group A, p < 0.001. A significant increase in CD8% was seen 6-month post-Tx among Group B compared to Group A. No difference was detected between groups in (CD4(+), CD8(+), CD4/CD8, CD3-CD16/65(+)%), rate and severity of intercurrent infection, rate of acute rejection, 12 months post-Tx. A significantly higher rate of severe infections particularly urinary tract infections (UTI) was noted in Group B compared to Group A the first 3 months post-Tx particularly in those who received the combination of antithymocyte globulin (ATG) or basiliximab, tacrolimus, steroids, mycophenolate mofetil (MMF). CD4(+)% correlated negatively with intercurrent infections in Group B 6 months post-Tx.
HCV(+) patients are more prone to intercurrent infections the first 3 months post-Tx. Infection rate correlates positively with pre-transplant HCV seropositivity and immunosuppressive regimen.
我们评估了丙型肝炎血清学阳性对活体供肾移植受者（LDRTRs）中各种T细胞百分比的影响，以及它们与肾移植术后（移植后）并发感染的相关性。
前瞻性研究了133例匹配的LDRTRs[通过酶联免疫吸附测定法分为A组（血清阴性）（68例患者）和B组（血清阳性）（65例患者）]，在移植后10天、6个月和12个月通过流式细胞术检测并发感染、急性排斥反应和T细胞百分比。
与A组相比，B组在移植后10天时CD4(+)、CD8(+)、CD4/CD8显著更高，p<0.001。与A组相比，B组在移植后6个月时CD8%显著增加。在移植后12个月时，两组在（CD4(+)、CD8(+)、CD4/CD8、CD3 - CD16/65(+)%）、并发感染的发生率和严重程度、急性排斥反应的发生率方面未检测到差异。与A组相比，B组在移植后前3个月尤其是接受抗胸腺细胞球蛋白（ATG）或巴利昔单抗、他克莫司、类固醇、霉酚酸酯（MMF）联合治疗的患者中，严重感染尤其是尿路感染（UTI）的发生率显著更高。在移植后6个月时，B组中CD4(+)%与并发感染呈负相关。
HCV(+)患者在移植后前3个月更容易发生并发感染。感染率与移植前HCV血清学阳性和免疫抑制方案呈正相关。
