CC chemokine receptor 5delta32 polymorphism-a risk factor for ischemic-type biliary lesions following orthotopic liver transplantation.
Ischemic-type biliary lesions are a major complication following orthotopic liver transplantation. They occur in up to 26% of liver transplant recipients. Among other factors, unknown immunologic factors have always been assumed to be partly responsible for these lesions. CC-chemokines and their receptors play a key role in postoperative immunomodulation after liver transplantation. The non-function CC-chemokine receptor 5delta32 polymorphism (CCR5delta32) has been shown to lead to a lower rate of acute rejection after kidney transplantation; in liver transplantation the role of CCR5delta32 is unclear. We investigated the influence of the CCR5delta32 after liver transplantation with special regard to ischemic-type biliary lesions. The CC-chemokine receptor-5 (CCR5) of 146 recipients was analyzed by polymerase chain reaction to detect CCR5delta32 in blood samples of patients after liver transplantation. One hundred twenty patients with wild-type CCR5 and 26 patients with CCR5delta32 (1 homozygote, 25 heterozygote) were identified. Ischemic-type biliary lesions occurred in 14 of 120 patients with wild-type CCR5 and in 8 of 26 patients with CCR5delta32 polymorphism (P = = 0.01). 5 year patient survival with CCR5delta32 and CCR5 was 70% and 85%, respectively (P =.0067). Our results show that the CCR5delta32 is a significant risk factor for the development of ischemic-type biliary lesions after liver transplantation and leads to a reduction in 5-year survival. In conclusion, the CCR5 status should be screened prospectively before liver transplantation.
Department of Transplantation and Hepatobiliary Surgery, Johannes Gutenberg University, Mainz, Germany. moench@transplantation.klinik.uni-mainz.de
Christian
C
Moench
Anja
A
Uhrig
Ansgar W
AW
Lohse
Gerd
G
Otto
D000328:Adult; D001653:Bile Ducts, Intrahepatic / Q000098:blood supply* / Q000276:immunology; D001660:Biliary Tract Diseases / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007511:Ischemia / Q000235:genetics / Q000276:immunology*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology; D008875:Middle Aged; D011110:Polymorphism, Genetic; D019713:Receptors, CCR5 / Q000097:blood / Q000235:genetics* / Q000276:immunology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D019713:Receptors, CCR5