ArticleFrontiers in immunology2025
Persistent lymphopenia after kidney transplantation: increased mortality and decreased homeostatic mechanisms.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Alemtuzumab Induction via Intravenous vs. Subcutaneous Administration in Pediatric Kidney Transplantation.Pediatric transplantation · 2026Article
- Early Post-Transplant Changes in Nutritional Status Predict Long-Term Graft Loss and Mortality.Journal of clinical medicine · 2026Article
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Authors and funding
13 authors.
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Abstract
Introduction: Kidney transplant (KTx) recipients commonly develop transient lymphopenia due to treatment with alemtuzumab, rabbit anti-thymocyte globulin (rATG) or other conditions. However, persistent lymphopenia lasting for years has not been studied in detail. The goal of this study was to determine the prevalence of persistent lymphopenia, evaluate its association with mortality and investigate possible mechanisms by which it occurs. Methods: We retrospectively studied peripheral blood lymphocyte and leukocyte counts in 7307 adult, solitary renal transplant recipients transplanted between 1/2006 to 12/2020. Results: While leukocyte counts generally remained within the normal range, lymphocyte counts 3 years after KTx were below normal in 31% (compared to 14% pretransplant and 54% at 1 year). Increasing severity of lymphopenia at 3 years was associated with increasing risk of mortality. The major risk factors for lymphopenia at 3 years were: receiving alemtuzumab or rATG for induction or the treatment of rejection, increasing recipient age, pretransplant dialysis, a low lymphocyte count pretransplant, and having a prior kidney transplant. Mass cytometry immunophenotyping at 3 years showed that B cells, NK cells and all T cell subsets (CD4, CD8, naïve, memory, etc.) decreased with decreasing lymphocyte counts. This included fewer recent thymic emigrants, naïve T cells, and stem-cell like memory T cells (T Discussion: We conclude that persistent lymphopenia might be partially due to impaired homeostatic mechanisms in T, B and NK cells and might be a simple, useful biomarker for individualizing patient management.
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