title: Cell-mediated rejection results in allograft loss after liver cell transplantation.
abstract: Liver cell transplantation in humans has been impeded by invariable loss of the graft. It is unclear whether graft loss is due to an immune response against donor hepatocytes. Transplantation with ABO-matched liver cells was performed in a patient with Crigler-Najjar type 1. After successful engraftment, there was a gradual loss of graft function. Solid-phase enzyme immunoassay testing and cell-complement cytotoxicity assays detecting preformed antibodies directed toward class I and/or class II human leukocyte antigen (HLA) molecules were negative. In contrast, a striking host alloresponse to either the HLA-B39 or C7 antigen was found, suggesting that a vigorous response to a defined mismatched HLA antigen contributed to graft loss in our patient. This study provides evidence that a T-cell-mediated immune mechanism could be responsible for human liver cell transplant graft loss. This finding warrants confirmation in future liver cell transplants in humans.
authors.affiliation: Gut and Liver Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. katie.allen@rch.org.au
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Allen
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Mifsud
authors.forename: Robert
authors.initials: R
authors.lastname: Williamson
authors.forename: Patrick
authors.initials: P
authors.lastname: Bertolino
authors.forename: Winita
authors.initials: W
authors.lastname: Hardikar
mesh_terms: D002648:Child; D003414:Crigler-Najjar Syndrome / Q000276:immunology / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D015235:HLA-B Antigens / Q000276:immunology; D059946:HLA-B39 Antigen; D015236:HLA-C Antigens / Q000276:immunology; D022781:Hepatocytes / Q000276:immunology / Q000637:transplantation*; D006801:Humans; D007111:Immunity, Cellular; D016031:Liver Transplantation; D012086:Reoperation; D013601:T-Lymphocytes / Q000276:immunology*; D013997:Time Factors; D014184:Transplantation, Homologous; D017211:Treatment Failure
chemical_list: D015235:HLA-B Antigens; D059946:HLA-B39 Antigen; D015236:HLA-C Antigens