Pretransplantation recipient regulatory T cell suppressive function predicts delayed and slow graft function after kidney transplantation

Minh Tri J.P. Nguyen, Elise Fryml, Sossy K. Sahakian, Shuqing Liu, Rene P. Michel, Mark L. Lipman, Istvan Mucsi, Marcelo Cantarovich, Jean I. Tchervenkov, Steven Paraskevas

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10 Citations (Scopus)


Background. Delayed graft function (DGF) and slow graft function (SGF) are a continuous spectrum of ischemiareperfusionYrelated acute kidney injury (AKI) that increases the risk for acute rejection and graft loss after kidney transplantation. Regulatory T cells (Tregs) are critical in transplant tolerance and attenuate murine AKI. In this prospective observational cohort study, we evaluated whether pretransplantation peripheral blood recipient Treg frequency and suppressive function are predictors of DGF and SGF after kidney transplantation. Methods. Deceased donor kidney transplant recipients (n=53) were divided into AKI (n=37; DGF, n=10; SGF, n=27) and immediate graft function (n=16) groups. Pretransplantation peripheral blood CD4+CD25hiFoxP3+ Treg frequency was quantified by flow cytometry. Regulatory T-cell suppressive function was measured by suppression of autologous effector T-cell proliferation by Treg in co-culture. Results. Pretransplantation Treg suppressive function, but not frequency, was decreased in AKI recipients (PG0.01). In univariate and multivariate analyses accounting for the effects of cold ischemic time and donor age, Treg suppressive function discriminated DGF from immediate graft function recipients in multinomial logistic regression (odds ratio, 0.77; PG0.01), accurately predicted AKI in receiver operating characteristic curve (area under the curve, 0.82; PG0.01), and predicted 14-day estimated glomerular filtration rate in linear regression (PG0.01). Conclusion. Our results indicate that recipient peripheral blood Treg suppressive function is a potential independent pretransplantation predictor of DGF and SGF.

Original languageEnglish
Pages (from-to)745-753
Number of pages9
Issue number7
Publication statusPublished - Oct 15 2014



  • Acute kidney injury
  • Delayed graft function
  • Kidney transplantation
  • Treg

ASJC Scopus subject areas

  • Transplantation

Cite this

Nguyen, M. T. J. P., Fryml, E., Sahakian, S. K., Liu, S., Michel, R. P., Lipman, M. L., Mucsi, I., Cantarovich, M., Tchervenkov, J. I., & Paraskevas, S. (2014). Pretransplantation recipient regulatory T cell suppressive function predicts delayed and slow graft function after kidney transplantation. Transplantation, 98(7), 745-753.