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Ius, Fabio; Salman, Jawad; Knoefel, Ann-Kathrin; Sommer, Wiebke; Nakagiri, Tomoyuki; Verboom, Murielle; Siemeni, Thierry; Poyanmehr, Reza; Bobylev, Dmitry; Kuehn, Christian; Avsar, Murat; Erdfelder, Caroline; Hallensleben, Michael; Boethig, Dietmar; Hecker, Hartmut; Schwerk, Nicolaus; Müller, Carsten; Welte, Tobias; Falk, Christine; Preissler, Gerhard; Haverich, Axel; Tudorache, Igor and Warnecke, Gregor (2020): Increased frequency of CD4(+)CD25(high)CD127(low) T cells early after lung transplant is associated with improved graft survival - a retrospective study. In: Transplant International, Vol. 33, No. 5: pp. 503-516

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In this retrospective study, we analyzed the presence of any association of three CD4(+)CD25(high) regulatory T-cell subpopulations at 3 weeks after lung transplantation with the later incidence of chronic lung allograft dysfunction and graft survival. Among lung-transplanted patients between January 2009 and April 2018, only patients with sufficient T-cell measurements at 3 weeks after transplantation were included into the study. Putative regulatory T cells were defined as CD4(+)CD25(high) T cells, detected in peripheral blood and further analyzed for CD127(low), FoxP3(+), and CD152(+) using fluorescence-activated cell sorting (FACS) analysis. Associations of regulatory T cells with chronic lung allograft dysfunction (CLAD) and graft survival were evaluated using Cox analysis. During the study period, 724 (71%) patients were included into the study. Freedom from chronic lung allograft dysfunction (CLAD) and graft survival amounted to 66% and 68% at 5 years. At the multivariable analysis, increasing frequencies of CD127(low) were associated with better freedom from CLAD (hazard ratio for each 1% increase of %CD127(low), HR = 0.989, 95% CI = 0.981-0.996, P = 0.003) and better graft survival (HR = 0.991, 95% CI = 0.984-0.999, P = 0.026). A higher frequency of CD127(low) regulatory T cells in peripheral blood early after lung transplantation estimated a protective effect against chronic lung allograft dysfunction, mortality, and re-transplantation.

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