Natural killer cells and natural killer T cells in patients with renal transplantation1

Abstract

Abstract Notwithstanding high clinical standards, renal transplantation, as the established procedure for treating terminal renal failure, involves the risk of numerous complications, especially in the postoperative period. Rejection episodes and bacterial, viral as well as fungal infections are of particular relevance. Frequently their timely clinical as well as laboratory identification and the resulting therapeutic consequences are too imprecise. This paper describes a practice-oriented concept for immunological monitoring within 28 days of observation following transplantation, including natural killer cells (NK) and natural killer T cells (NKT cells). This monitoring process focuses on flow cytometric identification of the functional markers NKp30, NKp44, NKp46, CD16 and CXCR3 on NK and NKT cells. Both cell populations were influenced by the therapy. While there was hardly any difference between living and cadaver donors and while no significant differences were found between the immunosuppressants, NKT cell findings in particular appear to make a diagnostic use of these cells possible while the graft is being monitored. The development of these cells following renal transplantation shows the changes typical under standard immunosuppression and permits the identification of postoperative complications.