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

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Abstract

Purpose of review

To 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 findings

The aged immune system is characterized by a decline in naïve 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.

Summary

Optimization of care for organ transplantation in older patients requires an improved understanding of immune cell aging and its pleotropic effects.

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This work was supported by awards to JSM from the Veterans Administration (1I01CX001971).

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  1. Geriatric Research Education and Clinical Center, VA Palo Alto Health Care System, VA Palo Alto, 3801 Miranda Ave, Building 710, Room 2-202C, Palo Alto, CA, 94304, USA

    Christiane Rollenhagen & Jonathan S Maltzman

  2. Department of Medicine/Nephrology, Stanford University, Palo Alto, CA, USA

    Jonathan S Maltzman

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JSM is a member of the scientific advisory board of Qihan Biotec and has a family member who is employed by Iconovir.

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Rollenhagen, C., Maltzman, J.S. The Effects of Aging on Solid Organ Transplantation—Characteristics and Consequences of Immunosenescence. Curr Transpl Rep 10, 135–146 (2023). https://doi.org/10.1007/s40472-023-00405-5

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