Long-term follow-up of donor chimerism and tolerance after human liver transplantation.
We aimed to quantify peripheral donor chimerism (DC) and to analyze its association with graft and recipient outcome. Forty-two liver transplant recipients and their respective donors were studied, providing a total of 148 posttransplantation serum samples. DC was assessed with real-time quantitative polymerase chain reaction (qPCR) to detect polymorphic markers. DC did not decrease with time post-transplantation and was higher in child recipients versus adults and in recipients of deceased donor liver transplants versus recipients of live donor liver transplants. Higher levels of DC were detected in Rh-positive blood group donors, in O blood group recipients versus A blood group recipients, and in recipients with hepatitis C virus versus recipients with alcoholic cirrhosis. High DC was associated with patients with organ damage due to recurrent disease and rejection. Stable, high levels of DC, in the absence of other major clinical events, may thus be a marker of transplantation tolerance, and this knowledge may help to tailor immunosuppressive treatment. In conclusion, qPCR is a useful technique for DC follow-up in liver transplantation, although the evolution of DC levels should be analyzed in accordance with the clinical outcome of the patient.
Ayala
Rosa
R
Haematology Service, Hospital 12 de Octubre, Madrid, Spain.
Grande
Silvia
S
Albizua
Enriqueta
E
Crooke
Almudena
A
Meneu
Juan Carlos
JC
Moreno
Almudena
A
Pérez
Baltasar
B
Gilsanz
Florinda
F
Moreno
Enrique
E
Martínez-Lopez
Joaquín
J
D000017:ABO Blood-Group System / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D002648:Child; D002675:Child, Preschool; D046528:Chimerism; D004247:DNA / Q000097:blood / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006084:Graft Rejection / Q000235:genetics / Q000276:immunology; D006086:Graft vs Host Disease / Q000235:genetics / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D016019:Survival Analysis; D023001:Transplantation Tolerance / Q000235:genetics* / Q000276:immunology*; D055815:Young Adult
D000017:ABO Blood-Group System; D004247:DNA