@ARTICLE{10.3389/ti.2022.10639, AUTHOR={Rovira, Jordi and Ramirez-Bajo, Maria Jose and Bañón-Maneus, Elisenda and Hierro-Garcia, Natalia and Lazo-Rodriguez, Marta and Piñeiro, Gaston J. and Montagud-Marrahi, Enrique and Cucchiari, David and Revuelta, Ignacio and Cuatrecasas, Miriam and Campistol, Josep M. and Ricart, Maria Jose and Diekmann, Fritz and Garcia-Criado, Angeles and Ventura-Aguiar, Pedro}, TITLE={Immune Profiling of Peripheral Blood Mononuclear Cells at Pancreas Acute Rejection Episodes in Kidney-Pancreas Transplant Recipients}, JOURNAL={Transplant International}, VOLUME={35}, YEAR={2022}, URL={https://www.frontierspartnerships.org/articles/10.3389/ti.2022.10639}, DOI={10.3389/ti.2022.10639}, ISSN={1432-2277}, ABSTRACT={Profiling of circulating immune cells provides valuable insight to the pathophysiology of acute rejection in organ transplantation. Herein we characterized the peripheral blood mononuclear cells in simultaneous kidney-pancreas transplant recipients. We conducted a retrospective analysis in a biopsy-matched cohort (n = 67) and compared patients with biopsy proven acute rejection (BPAR; 41%) to those without rejection (No-AR). We observed that CD3+ T cells, both CD8+ and CD4+, as well as CD19+ B cells were increased in patients with BPAR, particularly in biopsies performed in the early post-transplant period (<3 months). During this period immune subsets presented a good discriminative ability (CD4+ AUC 0.79; CD8+ AUC 0.80; B cells AUC 0.86; p < 0.05) and outperformed lipase (AUC 0.62; p = 0.12) for the diagnosis of acute rejection. We further evaluated whether this could be explained by differences in frequencies prior to transplantation. Patients presenting with early post-transplant rejection (<3 months) had a significant increase in T-cell frequencies pre-transplant, both CD4+ T cells and CD8+ T cells (p < 0.01), which were associated with a significant inferior rejection-free graft survival. T cell frequencies in peripheral blood correlated with pancreas acute rejection episodes, and variations prior to transplantation were associated with pancreas early acute rejection.} }