Unique histopathological features of graft biopsies with liver function abnormalities in living donor liver transplant patients receiving basiliximab induction therapy.
Induction with basiliximab (BXM) has been confirmed as an effective treatment regimen for prophylaxis of acute cellular rejection (ACR). From 1991 to 2008, 116 living donor liver transplantations (LDLTs) were performed. Among these, 50 were included in this study. We compared calcineurin inhibitor plus steroid treatment without BXM (n = 14, control group) and with BXM (n = 36, BXM group). Although the rates of biopsied patients with abnormal serum biochemical tests (SBTs) were similar in the control (10/14, 71.4%) and BXM (21/36, 58.3%) groups, ACR was diagnosed in 9/10 (90.0%) patients in the control group compared with 4/21 (19.0%) patients in the BXM group. In accordance with the histopathological diagnosis, there was a significant difference in the ratios of peripheral CD4(+) CD25(+) T cells at five wk after LDLT between patients with and without ACR in the BXM group. Next, we divided the 32 patients without ACR in the BXM group into two groups: biopsied patients with abnormal SBTs and non-biopsied patients. The donor age of the biopsied patients was significantly higher than that of the non-biopsied patients. Induction with BXM reduced the incidence of ACR, and unique pathological phenomena responsible for graft dysfunction after LDLT with an increased incidence of abnormal SBTs were observed.
Advanced Surgical Science and Technology Division, Department of Surgery, Graduate School of Medicine, University of Tohoku, Aoba-ku, Sendai, Japan. satokazu@mail.tains.tohoku.ac.jp
Kazushige
K
Sato
Satoshi
S
Sekiguchi
Naoki
N
Kawagishi
Yorihiro
Y
Akamatsu
Kazuyuki
K
Ishida
Daizo
D
Fukushima
Shigeto
S
Miyagi
Ikuo
I
Takeda
Masaaki
M
Yamaguchi
Shirou
S
Oguma
Keisei
K
Fujimori
Akira
A
Sato
Susumu
S
Satomi
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D001706:Biopsy; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology* / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017093:Liver Failure / Q000473:pathology* / Q000628:therapy; D008111:Liver Function Tests; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D011182:Postoperative Care; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab