Pediatric patients receiving ABO-incompatible living related liver transplantation exhibit higher serum transforming growth factor-β1, interferon-γ and interleukin-2 levels.
BACKGROUND
ABO-incompatible liver transplantation (LTx) is becoming more common in response to the paucity of liver allografts. Several studies have expressed concern about the effect of ABO compatibility on graft survival.


OBJECTIVE
To evaluate the differences in serum cytokine levels between ABO-incompatible (ABO-i) and ABO-compatible (ABO-c; includes ABO-compatible and identical) pediatric LTx recipients during regular outpatient follow-up. Note that, in the field of organ transplantation, transplants are categorized as incompatible, compatible or identical; accordingly, these are the terms we use in the paper.


METHODS
A clinical outpatient study measuring serum transforming growth factor (TGF)-β1, interferon (IFN)-γ, interleukin (IL)-2 and IL-10 in 43 living related liver transplantation (LRLT) recipients, of whom 36 received ABO-c LRLT (34 were ABO-identical and 2 were non-identical) and 7 ABO-i LRLT. Serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, gamma-glutamyl transpeptidase, alkaline phosphatase, lactate dehydrogenase and bilirubin were measured as part of the patients' regular follow-up visits.


RESULTS
There were no differences between the ABO-c and ABO-i groups in terms of recipient's age [mean 12.6 vs. 11.1 years (y)], post-LTx duration (mean 7.3 vs. 7.3 y), donor's age (mean 35.5 vs. 34.6 y), body weight (28.9 ± 2.9 vs. 27.9 ± 6.9 kg), or gender (19 female and 17 male vs. 4 female and 3 male). Serum TGF-β1, IFN-γ and IL-2 were significantly higher in the ABO-i group than in the ABO-c group. IL-10, however, did not differ between the two groups. There was a tendency toward higher γGTP levels in the ABO-i group, but this difference did not reach significance.


CONCLUSIONS
ABO-incompatible LRLTx patients have higher serum TGF-β1, IFN-γ and IL-2 levels as measured at regular outpatient visits. As a result, they face a higher risk of T-helper 1 cell polarization, which could make graft rejection more likely.
Department of Pediatric Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan. hamed@fujita-hu.ac.jp
Mohamed Hamed
MH
Hussein
Takashi
T
Hashimoto
Ghada
G
AbdEl-Hamid Daoud
Takazumi
T
Kato
Masahito
M
Hibi
Hirokazu
H
Tomishige
Fujio
F
Hara
Tatsuya
T
Suzuki
Yoko
Y
Nakajima
Tatenobu
T
Goto
Tetsuya
T
Ito
Ineko
I
Kato
Atsushi
A
Sugioka
Hajime
H
Togari
D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000097:blood*; D007376:Interleukin-2 / Q000097:blood*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000276:immunology*; D019520:Living Donors; D008297:Male; D018709:Statistics, Nonparametric; D053773:Transforming Growth Factor beta1 / Q000097:blood*; D055815:Young Adult
D000017:ABO Blood-Group System; D007376:Interleukin-2; D053773:Transforming Growth Factor beta1; D007371:Interferon-gamma