title: Soluble fraction of class I human histocompatibility leukocyte antigens in the serum of liver transplant recipients.
abstract: In previous studies we reported a solid-phase, enzyme-linked immunoassay (ELISA) that can be used to quantitate the soluble fraction of human histocompatibility leukocyte class I antigens (S-HLA-I) and study their relevance in transplantation. In this study we determined the concentration and distribution of S-HLA-I in patients with end-stage liver disease (ESLD), as well as in liver transplant recipients. Sera were obtained from 51 patients with ESLD and 40 donor-recipient pairs. We analyzed the S-HLA-I in sera obtained from liver donors, as well as from liver transplant recipients (patients with ESLD), with sera from the latter obtained before and at various intervals up to 3 yr after transplantation. The results of the analyses justify the following conclusions: 1) Patients with ESLD had mean values of S-HLA-I (909 +/- 596 ng/ml) greater than those for the normal population (643 ng/ml) (P < 0.05); the S-HLA-I secretion decreased with increasing severity of liver disease. 2) Patients with tumors had mean S-HLA-I levels (399 ng/ml) significantly lower than those in patients with ESLD related to other causes. 3) In liver transplant recipients the S-HLA-I levels stabilized at approximately 1 month after transplant and remained relatively stable thereafter (mean level 950 +/- 536 ng/ml). The observed levels were also greater than those for the normal population (P < 0.05). 4) Preoperative and postoperative S-HLA-I values in liver transplant recipients demonstrated a biphasic distribution, dividing patients into high- and low-secretor groups. 5) During the post-transplant observation period, of these selected liver transplant recipients there was no difference between high- and low-secretor groups in the incidence of rejection (high, 70%; low, 67%), graft survival (high, 95%; low, 94%), or patient survival (high, 95%; low, 94%). 6) Measurement of the total amount of S-HLA-I, containing yet undefined ratios of both donor and recipient S-HLA-I, cannot be used to predict a state of tolerance in liver transplant recipients.
authors.affiliation: Department of Surgery, Louisiana State University/Willis-Knighton Medical Center, Shreveport, Louisiana 71130-3932, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: McMillan
authors.forename: F B
authors.initials: FB
authors.lastname: Gelder
authors.forename: G B
authors.initials: GB
authors.lastname: Zibari
authors.forename: D F
authors.initials: DF
authors.lastname: Aultman
authors.forename: I
authors.initials: I
authors.lastname: Adamashvili
authors.forename: J C
authors.initials: JC
authors.lastname: McDonald
mesh_terms: D004797:Enzyme-Linked Immunosorbent Assay; D006084:Graft Rejection; D015395:Histocompatibility Antigens Class I / Q000097:blood*; D006801:Humans; D008107:Liver Diseases / Q000276:immunology; D017093:Liver Failure / Q000209:etiology / Q000276:immunology; D016031:Liver Transplantation / Q000276:immunology*; D012995:Solubility; D014019:Tissue Donors
chemical_list: D015395:Histocompatibility Antigens Class I