title: Early immunological monitoring after pediatric liver transplantation: cytokine immune deviation and graft acceptance in 40 recipients.
abstract: Cytokine deviation may be a factor contributing to graft acceptance. We analyze, in the context of liver transplantation, circulating cytokine levels and their mRNA precursors in liver biopsy samples to study a putative correlation with early immunologic outcome. Forty primary pediatric liver recipients were submitted to a prospective immune monitoring protocol, including 8 of 40 patients with an early, biopsy-proven acute rejection episode. The 32 patients with graft acceptance showed markedly increased interleukin (IL)-10 blood levels at 2 hours after reperfusion on days 1 and 4 after transplantation as compared with baseline, whereas patients with graft rejection only exhibited increased IL-10 levels at 2 hours. A good correlation was observed between IL-10 peripheral levels and levels ascertained by IL-10 reverse transcriptase-polymerase chain reaction at 2 hours and on day 7. Patients with graft acceptance also showed a decrease in interferon gamma (IFN-gamma) at 1 and 2 hours after reperfusion on days 1, 4, 7, 14, and 28 after transplantation. One patient with graft tolerance who had subsequent immunosuppression withdrawal after posttransplantation lymphoproliferative disease showed a similar intraoperative IL-10 pattern, whereas posttransplantation tumor necrosis factor alpha and IFN-gamma levels greatly decreased. The occurrence of cytokine immune deviation may therefore be related to early graft acceptance in children who receive liver transplants.
authors.affiliation: Pediatric Surgical Unit, Saint Luc University Clinics, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Gras
authors.forename: Grégoire
authors.initials: G
authors.lastname: Wieërs
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Vaerman
authors.forename: Dinh Quang
authors.initials: DQ
authors.lastname: Truong
authors.forename: Etienne
authors.initials: E
authors.lastname: Sokal
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Otte
authors.forename: Béatrice
authors.initials: B
authors.lastname: Délépaut
authors.forename: Anne
authors.initials: A
authors.lastname: Cornet
authors.forename: Jean
authors.initials: J
authors.lastname: de Ville de Goyet
authors.forename: Dominique
authors.initials: D
authors.lastname: Latinne
authors.forename: Raymond
authors.initials: R
authors.lastname: Reding
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood / Q000276:immunology*; D005260:Female; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000276:immunology* / Q000473:pathology; D008297:Male; D015166:Monitoring, Immunologic / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018417:Th1 Cells / Q000276:immunology / Q000378:metabolism; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma