Low HLA-DR expression on monocytes as a prognostic marker for bacterial sepsis after liver transplantation.
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.
van den Berk
J M
JM
Department of Clinical Immunology, University Hospital, Groningen, The Netherlands.
Oldenburger
R H
RH
van den Berg
A P
AP
Klompmaker
I J
IJ
Mesander
G
G
van Son
W J
WJ
van der Bij
W
W
Sloof
M J
MJ
The
T H
TH
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*
D015415:Biomarkers; D006684:HLA-DR Antigens