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 Release 21.0, Jan 2008
 
Chapter : ch22. Immunology & Rheumatology Section : Transplantation
  T Cell Subsets in Renal Transplant Rejection

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Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

T cells are important in allograft rejection. Changes in T cell number, especially activated or cytotoxic T cells, may co-incide with transplant rejection or tolerance by the donor. Monitoring T cell subsets for predicting rejection is problematic and is infrequently done with improved immunosuppressive regimens.

 

Marker

Cell

Normal Percentage of Lymphocytes

CD2+

T cells, NK cells

72 - 92; 81 - 97; 65-90

CD2+, HLA-DR+

activated T cells

1.1 - 7.5

CD3+

T cells

53-88; 60-80

CD8+

T suppressor cells, T cytotoxic cells, NK cells

13 - 37; 13 - 49

CD8+, CD11b+

NK cells (CD8 on 10-80% NK cells)

1.1 - 16.3

CD8+, CD11b-

cytotoxic T cells

12.0 - 31.6

 

Increases in activated T cells (CD2+, HLA-DR+) and/or cytotoxic T cells (CD8+, CD11b-) are associated with either:

• acute allograft rejection

• severe viral infections.

 

Decreases in total T cells (CD3+) is associated with immunosuppression by antilymphocyte globulin or anti-T-cell monoclonal antibody.

 

ratio of activated T cells to total T cells =

= (CD2+, HLA-DR+) / (CD2+)

 

Interpretation of activated-to-total T cell ratio:

• normal: 0.03-0.10

 

Limitations:

• Because viral infections and other immune events can affect T cell subsets, this is infrequently used to guide intervention for allograft rejection.

 

  References:

Gern JE, Lederman HM. Chapter 15: Immunodeficiency. pages 254-275. (263). IN: Noe DA, Rock RC. Laboratory Medicine. Williams and Wilkins. 1994.

Hayes JM, Valenzuela R, et al. T11+/DR+ lymphocytes in renal allograft recipients with irreversible rejection. Transplantation. 1988; 45:806-809.

Kjeldsberg CR. Practical Diagnosis of Hematologic Disorders, 2nd edition. ASCP Press. 1995.pages 293-294, 317, 323-325.

Rose NR, de Macario EC , et al. Manual of Clinical Laboratory Immunology, 4th edition. 1992. page 838.

Tietz  NW (editor). Clinical Guide to Laboratory Tests, Third Edition. W.B. Saunders Co. 1995. pages 362-363

Tucker ES III, Nakamura RM, Hicks MJ. Chapter 30: Diagnostic immunology. pages 837-863 (855). IN: Howanitz JH, Howanitz PJ (editors). Laboratory Medicine - Test Selection and Interpretation. Churchill Livingstone. 1991.

 

 

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