Background: Over the last few years, there are two major problems identified during organ transplantation such as surgical restrictions and transplant rejections. Few of these obstacles have been partially removed such as the use of immunosuppressant improved it consistently while decreasing graft rejection up to 12.2%.

Methods: This study was conducted from 2019-2021. In all patients renal function was examined through glomerular filtration rate. Induction therapy was given to all the transplant recipients. Induction therapy with basiliximab 20mg intravenously on 0 and 4 days. After transplantation tacrolimus and MMF was given with varied concentration dose. Acute rejections were found in patients who had no biopsy or biopsy-proven rejection.  In the end, clinical pathologists had analyzed all biopsies again and recipients who were experienced the vascular Banff grade 2 and tubule interstitial rejection.

Results: Immunosuppressant tacrolimus treated patients were 71(67.61%) and mycophenolate mofetil used in 34(32.38%). Total 39(37.14%) rejections were received and 66(62.85%) acceptance was recorded. Two types of rejection were highlighted namely cell-mediated rejection 25(23.80%) and 14(13.33%) chronic antibody-mediated rejection. The effect of tacrolimus on follicular helper T cells and follicular regulatory T cells shows the clear difference between the kidney transplant and healthy control cells. Reduction in numbers of follicular regulatory T cells was measured in patients.

Conclusion: eventually we find tacrolimus significantly affects the number of follicular regulatory T-cells and follicular helper T cells. Alemtuzumab substantially lowers the follicular regulatory T-cells. Mycophenolate mofetil showed non-significant on T-cells.

Keywords: kidney transplant, follicular regulatory T-cells, follicular helper T-cells.