Practical Journal of Organ Transplantation(Electronic Version) ›› 2022, Vol. 10 ›› Issue (6): 531-536.DOI: 10.3969/j.issn.2095-5332.2022.06.011

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Immunological characteristics of peripheral blood lymphocytes infected with BK virus early after kidney transplantation

Chen Tingting 1 ,Zhu Dong 2,3 ,Yang Cheng 2,3 ,Wang Xuanchuan 2,3 ,Rong Ruiming 2,3 ,Zhu Tongyu 2,3 ,Li Xiaoyu 1 ,Wang Jina 2 .   

  1. 1.Department of Pharmacy,ZhongShan Hospital,Fudan University,Shanghai 200032,China ;

    2.Departmentof Urology,Zhongshan Hospital,Fudan University,Shanghai 200032,China ;

    3.Shanghai Key laboratory of Organ Transplantation,Shanghai 200032,China

  • Online:2022-11-20 Published:2023-03-27

肾移植术后早期 BK 病毒感染的外周血淋巴细胞免疫特征分析

陈婷婷 1 ,朱冬 2,3,杨橙 2,3,王宣传 2,3,戎瑞明 2,3,朱同玉 2,3,李晓宇 1 ,王继纳 2,3    

  1. 1. 复旦大学附属中山医院药剂科,上海 200032 ;

    2. 复旦大学附属中山医院泌尿外科,上海 200032 ;

    3. 上海市器官移植重点实验室,上海 200032

  • 基金资助:

    上海市自然科学基金面上项目(19ZR1409200) 

Abstract:

Objective We retrospectively analyzed the immune characteristics of lymphocytes in patients withBK virus(BKV)activation after renal transplantation,and compared the impact of the areas under the lymphocyte curve (L_AUC)on BKV activation after renal transplantation. Methods Among 154 consecutive patients who underwent their first renal transplantation at our center between 2020 and 2021,a total number of 131 patients who met the inclusion criteriawere retrospectively studied. We divided these patients into BKV negative group and BKV reactivation group based on theBKV-DNA load in urine and blood after renal transplantation. L_AUC was calculated as the area under the lymphocyte curve. We calculated L_AUC from day 0 to day 30. The risk factors for BKV reactivation and relationship with L_AUC in the early period after renal transplantation were analyzed. Results BKV activation was detected in 40 cases at six months after renal transplantation. The lymphocyte count was lower in BKV activation group than BKV negative group,and thereindependent risk factor for BKV activation(95% CI = 1.416 ~ 8.726,P = 0.007),and female was a protective factor (95% CI = 0.129 ~ 0.723,P = 0.007). Conclusion L_AUC is associated with BKV activation after renal transplantation,patients with low L_AUC30daysaftersurgery are morelikelyto haveBKVactivation. 

Key words:

Renal transplantation , Lymphocyte count , Areas under thelymphocyte curve , BKvirusactivation

摘要:

目的 探讨同种异体肾移植术后患者早期外周血淋巴细胞的免疫特征,并以外周血淋巴细胞曲线下面积(area under the lymphocyte curve,L_AUC)作为免疫重建指标,研究其与肾移植术后早期 BK病毒(BK virus,BKV)再激活的相关性。方法 选择 2020 年 1 月至 2021 年 10 月期间,在复旦大学附属中山医院接受同种异体肾移植手术的患者,对最终符合纳入标准的共 131 例患者进行回顾性研究。根据肾移植术后患者外周血淋巴细胞计数及 BKV-DNA 载量,统计 BKV 感染情况,计算术后第 1 天到第 30 天的L_AUC。其中 L_AUC 定义为淋巴细胞计数 - 时间曲线下的一系列淋巴细胞计数之和。分析导致肾移植术后早期 BKV 再激活的危险因素,以及 L_AUC BKV 再激活的相关性。结果 131 例肾移植患者中,共 40 例患者检测到 BKV 再激活,且均为 BKV 尿症。BKV 激活组患者肾移植术后 1 个月内外周血中淋巴细胞计数明显低于 BKV 阴性组,术后 30 d L_AUC 在两组患者间存在统计学差异。多因素回归分析显示,在对混杂因素进行较正后,低 L_AUC(95% CI 1.416 ~ 8.726,P 0.007)被确定为肾移植术后早期 BKV 激活的独立危险因素,女性(95% CI 0.129 ~ 0.723,P 0.007)为肾移植术后早期 BKV 再激活的保护因素。结论 外周血 L_AUC 与肾移植术后早期的 BKV 再激活相关,术后 30 d 内低 L_AUC 的肾移植患者更容易发生 BKV 的再激活。

关键词:

肾移植 , 淋巴细胞计数 , 淋巴细胞曲线下面积 , BK 病毒激活