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Natural killer cell function predicts severe infection in kidney transplant recipients
Author(s) -
Dendle Claire,
Gan PohYi,
Polkinghorne Kevan R.,
Ngui James,
Stuart Rhonda L.,
Kanellis John,
Thursky Karin,
Mulley William R.,
Holdsworth Stephen
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14900
Subject(s) - medicine , natural killer cell , odds ratio , confidence interval , logistic regression , immunology , renal function , kidney transplantation , cd16 , transplantation , immune system , cd8 , cytotoxic t cell , biology , cd3 , biochemistry , in vitro
The aim of this study was to determine if natural killer cell number (CD3 − /CD16 ± /CD56 ± ) and cytotoxic killing function predicts severity and frequency of infection in kidney transplant recipients. A cohort of 168 kidney transplant recipients with stable graft function underwent assessment of natural killer cell number and functional killing capacity immediately prior to entry into this prospective study. Participants were followed for 2 years for development of severe infection, defined as hospitalization for infection. Area under receiver operating characteristic ( AUROC ) curves were used to evaluate the accuracy of natural killer cell number and function for predicting severe infection. Adjusted odds ratios were determined by logistic regression. Fifty‐nine kidney transplant recipients (35%) developed severe infection and 7 (4%) died. Natural killer cell function was a better predictor of severe infection than natural killer cell number: AUROC 0.84 and 0.75, respectively ( P = .018). Logistic regression demonstrated that after adjustment for age, transplant function, transplant duration, mycophenolate use, and increasing natural killer function ( odds ratio [OR] 0.82, 95% confidence interval [CI] 0.74‐0.90; P < .0001) but not natural killer number ( OR 0.96, 95% CI 0.93‐1.00; P = .051) remained significantly associated with a reduced likelihood of severe infection. Natural killer cell function predicts severe infection in kidney transplant recipients.