Early immunological monitoring after pediatric liver transplantation: cytokine immune deviation and graft acceptance in 40 recipients.
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.
Gras
Jérémie
J
Pediatric Surgical Unit, Saint Luc University Clinics, Université Catholique de Louvain, Brussels, Belgium.
Wieërs
Grégoire
G
Vaerman
Jean-Luc
JL
Truong
Dinh Quang
DQ
Sokal
Etienne
E
Otte
Jean-Bernard
JB
Délépaut
Béatrice
B
Cornet
Anne
A
de Ville de Goyet
Jean
J
Latinne
Dominique
D
Reding
Raymond
R
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
D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma