Impact of preexisting circulating effector T cells on the outcome of ABO-incompatible adult LDLT.
Our aim was to clarify the significance of phenotype of circulating CD8 T(+) cells on the outcome of ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). Twenty-six recipients undergoing ABO-I LDLT and 92 undergoing ABO-compatible (ABO-C) LDLT were classified into three groups according to preoperative proportion of CD8 T(+) cells: naive-dominant (group I), effector memory-dominant (group II), and effector-dominant (group III) recipients. The clinical courses were analyzed. The results showed that in ABO-C groups I and II and in ABO-I group I, effector cells remained above the pretransplant levels after tacrolimus administration. However, in ABO-C group III and ABO-I groups II and III, effector cells were down-regulated for a prolonged period, along with markedly decreased perforin expression and frequent life-threatening complications. ABO-I group II and group III recipients had higher infection rates. It was concluded that recipients with preexisting high effector CD8 T(+) cells are unfavorable candidates for ABO-I LDLT.
Egawa
Hiroto
H
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan. egawa@kuhp.kyoto-u.ac.jp
Ozawa
Kazue
K
Takada
Yasutsugu
Y
Teramukai
Satoshi
S
Mori
Akira
A
Kasahara
Mureo
M
Ogawa
Kohei
K
Ogura
Yasuhiro
Y
Oike
Fumitaka
F
Kaido
Toshimi
T
Ono
Masako
M
Sato
Hiroshi
H
Takai
Kenji
K
Uemoto
Shinji
S
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D016031:Liver Transplantation / Q000276:immunology*; D019520:Living Donors; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology; D008875:Middle Aged; D010641:Phenotype; D016559:Tacrolimus / Q000494:pharmacology
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents; D016559:Tacrolimus; D008775:Methylprednisolone