Thymic output and homeostatic mature cell proliferation both influence T-cell repopulation following depletional induction, though the relative contribution of each and their association with recipient age have not been well studied. We investigated the repopulating T-cell kinetics in kidney transplant recipients who underwent alemtuzumab induction followed by belatacept/rapamycin-based immunosuppression over 36 months posttransplantation. We focused specifically on the correlation between repopulating T cell subsets and the age of patients. Substantial homeostatic Ki67-expressing T-cell proliferation was seen posttransplantation. A repertoire enriched for naïve T (T ) cells emerged posttransplantation. Analysis by generalized estimating equation linear models revealed a strong negative linear association between reconstituting T cells and advancing age. A relationship between age and persistence of effector memory cells was shown. We assessed thymic output and found an increase in the frequency of recent thymic emigrants (RTEs, CD4 CD31 ) at 12-month posttransplantation. Patients under 30 years of age showed significantly higher levels of CD4 CD31 cells than patients over 55 years of age pre and posttransplantation. IL-7 and autologous mature dendritic cells (mDCs) induced CD57 cell proliferation. In contrast, mDCs, but not IL-7, induced CD57 cell proliferation. This study establishes the relationship between age and thymic output during T-cell homeostatic repopulation after alemtuzumab induction.
This article is protected by copyright. All rights reserved.

Author