title: Impact of adjuvant immunotherapy using liver allograft-derived lymphocytes on bacteremia in living-donor liver transplantation.
abstract: BACKGROUND
  Bacteremia is one of the leading causes of mortality in living-donor liver transplant (LDLT) recipients. Lymphocytes, including natural killer cells, are believed to play a role in the first line of defense against invading infectious microbes.
  
  
  METHODS
  From January 2004 to December 2009, 114 consecutive LDLT recipients were studied for postoperative bacteremia. The impact of adjuvant immunotherapy using activated liver allograft-derived lymphocytes on bacteremia was retrospectively evaluated by a one-to-one match using propensity score to overcome bias due to the different distribution of covariates for the two groups.
  
  
  RESULTS
  After one-to-one matching, 21 patients who did not receive adjuvant immunotherapy and 21 who did not receive adjuvant immunotherapy had the same preoperative and operative characteristics. Six (28.6%) of the 21 patients who did not receive adjuvant immunotherapy had bacteremia, whereas only one (4.8%) of the 21 patients who received adjuvant immunotherapy had bacteremia; thus, the incidence of bacteremia in patients who had received adjuvant immunotherapy was significantly lower than that in patients who had not received adjuvant immunotherapy (P=0.038).
  
  
  CONCLUSIONS
  Adjuvant immunotherapy using liver allograft-derived lymphocytes may be a promising modality for reducing the postoperative bacteremia after LDLT.
authors.affiliation: Department of Transplantation Surgery, Hiroshima University Hospital, Hiroshima, Japan. htashiro@hiroshima-u.ac.jp
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishiyama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohira
authors.forename: Yuka
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tahara
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ide
authors.forename: Takashi
authors.initials: T
authors.lastname: Onoe
authors.forename: Yuka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007694:Killer Cells, Natural / Q000276:immunology / Q000637:transplantation; D008099:Liver / Q000166:cytology / Q000276:immunology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology*; D019520:Living Donors; D008213:Lymphocyte Activation; D017710:Lymphocyte Transfusion; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D055611:Natural Killer T-Cells / Q000276:immunology / Q000637:transplantation; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D055815:Young Adult