title: Low HLA-DR expression on monocytes as a prognostic marker for bacterial sepsis after liver transplantation.
abstract: BACKGROUND
  Low HLA-DR expression on monocytes is associated with an increased risk of infection after surgery or trauma. We determined the value of this parameter as a marker for sepsis after liver transplantation.
  
  
  METHODS
  The percentage of monocytes expressing HLA-DR was determined by flow cytometry before and after liver transplantation in nine patients. Five lung and 20 kidney transplant recipients served as controls.
  
  
  RESULTS
  Bacterial sepsis occurred in 5 of 9 liver transplant patients and 0 of 24 control patients. Monocyte HLA-DR expression decreased <50% in all five patients with sepsis. HLA-DR expression dropped before (n=4) or at the time of sepsis (n=1), and remained low for 13 weeks. HLA-DR expression remained >50% in the four liver transplant patients without sepsis. Only 1 of 25 control patients had persistently low monocyte HLA-DR expression.
  
  
  CONCLUSIONS
  Monitoring of monocyte HLA-DR expression may be helpful in identifying liver transplant patients who have an increased risk of imminent bacterial sepsis.
authors.affiliation: Department of Clinical Immunology, University Hospital, Groningen, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: van den Berk
authors.forename: R H
authors.initials: RH
authors.lastname: Oldenburger
authors.forename: A P
authors.initials: AP
authors.lastname: van den Berg
authors.forename: I J
authors.initials: IJ
authors.lastname: Klompmaker
authors.forename: G
authors.initials: G
authors.lastname: Mesander
authors.forename: W J
authors.initials: WJ
authors.lastname: van Son
authors.forename: W
authors.initials: W
authors.lastname: van der Bij
authors.forename: M J
authors.initials: MJ
authors.lastname: Sloof
authors.forename: T H
authors.initials: TH
authors.lastname: The
mesh_terms: D015415:Biomarkers; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000096:biosynthesis*; D006801:Humans; D016031:Liver Transplantation / Q000276:immunology; D009000:Monocytes / Q000276:immunology* / Q000378:metabolism; D011183:Postoperative Complications / Q000276:immunology*; D011379:Prognosis; D018805:Sepsis / Q000097:blood / Q000276:immunology*
chemical_list: D015415:Biomarkers; D006684:HLA-DR Antigens