Image 2_Pre-transplant T-cell clonal analysis identifies CD8+ donor reactive clones that contribute to kidney transplant rejection.tiff

Introduction<p>Responses to allogeneic human leukocyte antigen (HLA) molecules limit the survival of transplanted organs. The changes in T-cell alloreactivity that contribute to this process, however, are not fully understood. We defined a set of donor reactive T-cell clones (DRTC) with the go...

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Main Author: Jes M. Sanders (4984874) (author)
Other Authors: Barbara L. Banbury (3361694) (author), Erika L. Schumacher (20683793) (author), Jie He (132999) (author), Yuvaraj Sambandam (20683796) (author), Paul A. Fields (11355829) (author), Lorenzo Gallon (756973) (author), James M. Mathew (20683799) (author), Joseph R. Leventhal (9709541) (author)
Published: 2025
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Summary:Introduction<p>Responses to allogeneic human leukocyte antigen (HLA) molecules limit the survival of transplanted organs. The changes in T-cell alloreactivity that contribute to this process, however, are not fully understood. We defined a set of donor reactive T-cell clones (DRTC) with the goal to elucidate signatures of kidney allograft rejection.</p>Methods<p>DRTC were identified pretransplant using an anti-donor mixed lymphocyte reaction assay: CFSE-diluting CD4<sup>+</sup> and CD8<sup>+</sup> DRTC were flow-sorted, and the TCR sequences were identified using Adaptive Immunosequencing. DRTC were then tracked in post-transplant biopsies, blood, and urine samples in a cohort of kidney transplant recipients.</p>Results<p>In patients with an abnormal biopsy, the majority of CD8<sup>+</sup> DRTC found within the allograft were detected in the circulating pre-transplant repertoire. Circulating CD8<sup>+</sup> DRTC were more abundant pre- and post-transplant in patients that received non-lymphodepletional induction and developed an abnormal biopsy when compared to stable patients. Additionally, DRTC were detected as early as two weeks post-transplant in the urine of some patients, with some of these clones subsequently identified in follow-up kidney biopsy samples.</p>Discussion<p>The findings of our study add to our understanding of T-cell alloreactivity following kidney transplantation and provide evidence for the role of pre-defined alloreactive T-cells in the development of allograft rejection.</p>