Thymic function decreases progressively with age but may be boosted in certain circumstances. We questioned whether heart transplantation was such a situation and whether thymic function was related to the onset of rejection. Twenty-eight antithymocyte globulin-treated heart transplant recipients were included. Patients diagnosed for an antibody-mediated rejection on endomyocardial biopsy had a higher proportion of circulating recent thymic emigrant CD4+ T cells and T cell receptor excision circle levels than other transplanted subjects. Thymus volume and density, assessed by computed tomography in a subset of patients, was also higher in patients experiencing antibody-mediated rejection. We demonstrate that thymic function is a major determinant of onset of antibody-mediated rejection and question whether thymectomy could be a prophylactic strategy to prevent alloimmune humoral responses.
Keywords: basic (laboratory) research/science; heart (allograft) function/dysfunction; heart transplantation/cardiology; immunobiology; immunosuppressant - polyclonal preparations: rabbit antithymocyte globulin; monitoring: immune; rejection: antibody-mediated (ABMR); thymus/thymic biology; translational research/science.
© 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.