THE ROLE OF LYMPHOCYTE IMMUNOPHENOTYPING IN IMMUNE-MEDIATED INJURY TO A KIDNEY TRANSPLANT FROM A DONOR WITH DIAGNOSED BRAIN DEATH

Abstract

Immune-mediated injury to a renal allograft remains one of the leading causes of graft loss in the late post-transplant period. Modern transplantation immunology considers rejection as a complex multilevel process involving cellular, humoral, and molecular mechanisms of the alloimmune response. This paper reviews current literature on the role role of lymphocyte immunophenotyping in the diagnosis and prediction of antibody-mediated and T-cell rejection, evaluating the diagnostic and prognostic value of Treg, Breg, and NK cells, donor-specific antibodies, updated Banff criteria, and immunological monitoring protocols. The aim - to review scientific sources on the current state of research regarding immune-mediated kidney allograft injury, and to analyze the correlation of T- and B-cell immunophenotypes—particularly Treg and Breg subpopulations—with morphological data in recipients of kidney transplants from donors diagnosed with brain death (DBD). Conclusions. Immune-mediated allograft injury is a complex, stepwise process that includes cellular, humoral, and molecular mechanisms of the humoral response. Modern dynamic  immunological diagnostic monitoring opens up prospects for a personalized approach in transplantation.