Anti-donor T cell responses are equivalent between elderly and non-elderly kidney transplant recipients

Abstract

Although the number of kidney transplantations (KTs) among elderly patients has been increasing, no specific recommendations have been established for managing elderly patients. In this study, we investigated the influence of aging on anti-donor T-cell responses by comparing elderly (aged ≥ 60 years) and non-elderly KT recipients with cyclosporine-based immunosuppressive regimens. We performed a serial mixed lymphocyte reaction assay to evaluate the status of T-cell immunity in KT recipients. During the observation period, a certain number of patients in both groups presented with hyper T-cell responses to donor stimuli. Notably, the proportion of patients showing anti-donor hyper-responsiveness in the elderly group gradually increased over time with a reduced dosage of immunosuppressants.In conclusion, anti-donor T cell responses were equivalent between elderly and non-elderly recipients. Thus, caution is required regarding the imprudent reduction of immunosuppressants in elderly recipients. A rigorously designed, large-scale, prospective study is needed to validate these results.