Pretransplant expression of CD45RC, expressed on CD8+ T cells has been associated with the risk of developing acute rejection (AR) at five years of follow-up in kidney transplant recipient (KTR). The objective of the present study was to analyze the relationship between pretranspalnt CD45RC expression on T cells and the post-transplant outcomes, including AR and cancer in the long-term follow-up.
Methods. Pre-transplant expression of CD45RC on CD4+ and CD8+ circulating blood T cells was determined in a cohort of 89 consecutives, first time KTR. AR, cancers and deaths were retrospectively registered and characterized. The relationship between frequencies of both CD4+ and CD8+CD45RC T cells subsets and post-transplant events was analyzed.
Results. AR, cancer and patient death occured in 20 (22.5%), 25 (28.1%) and 14 (15.7) patients, respectively after a mean follow-up of 11 years. Pre-transplant frequency of CD8+CD45RChigh T cells >54.3% was strongly associated with AR conferring a 4-7 fold increased risk after adjustment on classical risk factors. Cancer was associated with a decreased proportion of CD4+CD45RChigh T cells, with a frequency < 51.9% conferring a 3.5-5.5 increased risk of malignancy. Frequencies of CD4+ and CD8+CD45RChighT cells were positively correlated (p < 0.0001) suggesting that recipients at high AR risk display a low cancer risk.