Monitoring CD3(+) T Cells in Kidney Transplantation and Immunosuppression Adequacy.

BACKGROUND

Monitoring CD3(+) T-cell counts in kidney transplant recipients can provide valuable insights into immunosuppressive therapy effectiveness. This study aimed to evaluate the use of CD3(+) T-cell levels as biomarkers for immunosuppression adequacy and to assess their predictive value for acute rejection post-transplantation.

METHODS

A retrospective review was conducted involving 130 kidney transplant recipients who received induction therapy with antithymocyte globulin (ATG). CD3(+) T-cell percentages and absolute counts were measured using flow cytometry on postoperative day 5. Immunosuppression was maintained with tacrolimus, initiated upon clinical indicators of graft function recovery.

RESULTS

Among monitored patients, the median CD3(+) T-cell percentage was 48%, and median absolute count was 0.14 × 10⁹/L. Acute rejection occurred in 9.9% of recipients. Higher CD3(+) T-cell values significantly correlated with acute rejection (64.0% vs 47.5%, p = .011; absolute count 0.28 vs 0.13 × 10⁹/L, p = .032). ROC analysis identified optimal predictive thresholds: 54% for CD3(+) percentage (sensitivity 85.7%, specificity 73.4%) and 0.21 × 10⁹/L for absolute count (sensitivity 85.7%, specificity 75.0%).

CONCLUSIONS

CD3(+) T-cell monitoring effectively guides individualized immunosuppressive strategies, significantly predicting acute rejection risks and optimizing graft outcomes.