Do CD4+Foxp3+ Treg cells correlate with transplant outcomes: A systematic review on recipients of solid organ transplantation

Regulatory T cells (Tregs) are considered to be critical for the induction of transplant tolerance. Tregs counts were measured in blood, biopsy and urine sample after transplantation in many studies. Although not unanimous, some studies have suggested that Tregs is associated with better outcome and can also serve as an immune marker to predict the individual risk of rejection and identify tolerant patients. In this study, we systematically reviewed the correlation between Tregs and transplant outcomes, identifying if Tregs can predict transplant rejection and tolerance. A total of 22 articles were included and assessed, the results showed that Tregs in recipients are helpful to maintain a stable graft function, reduce acute/chronic rejection rate. And the Tregs in graft and urine, rather than in PBL, may have a better diagnostic value for transplant outcomes. However, since the low quality of included studies, results may be influenced by bias. More high quality studies with bigger sample size are still needed in future.

► Meta-analysis was conducted to evaluate the correlation between Tregs counts and graft function or survival.
► We summarized the main findings of studies on relationship between Tregs counts and AR/CR/tolerance.
► We discussed different Treg indicators advantages and disadvantages, and discussed the possible future research directions.