The Effects of Aging on Solid Organ Transplantation-Characteristics and Consequences of Immunosenescence

摘要

Purpose of reviewTo discuss how T, natural killer (NK), and B cell aging modifies outcomes of organ transplantation, the transplant recipient's efficacy to vaccines, susceptibility to reactivation of latent viral infections, as well as organ quality and function.Recent findingsThe aged immune system is characterized by a decline in naive T cells and an increase of memory T cells, many of which also express innate markers. NK cells demonstrate a decline in cytokine secretion, cytotoxicity, and immune recognition. A population of pro-inflammatory B lymphocytes termed age-associated B cells (ABCs) expands with age. Functional changes in the aged immune cells induce inflammation and are less effective at controlling infection, mounting vaccine responses, and contributing to allorejection.Optimization of care for organ transplantation in older patients requires an improved understanding of immune cell aging and its pleotropic effects.