title: Immunological aspects in late phase of living donor liver transplant patients: usefulness of monitoring peripheral blood CD4+ adenosine triphosphate activity.
abstract: OBJECTIVE
  To evaluate whether the combination of the peripheral blood CD4+ adenosine triphosphate activity (ATP) assay (ImmuKnow assay: IMK assay) and cytochrome P450 3A5 (CYP3A5) genotype assay is useful for monitoring of immunological aspects in the patient followup of more than one year after living donor liver transplantation (LDLT).
  
  
  METHODS
  Forty-nine patients, who underwent LDLT more than one year ago, were randomly screened by using IMK assay from January 2010 to December 2011, and the complete medical records of each patient were obtained. The CYP3A5 genotypes were examined in thirty-nine patients of them.
  
  
  RESULTS
  The mean ATP level of the IMK assay was significantly lower in the patients with infection including recurrence of hepatitis C (HCV) (n = 10) than in those without infection (n = 39): 185 versus 350 ng/mL (P < 0.001), while it was significantly higher in the patients with rejection (n = 4) than in those without rejection (n = 45): 663 versus 306 ng/mL (P < 0.001). The IMK assay showed favorable sensitivity/specificity for infection (0.909/0.842) as well as acute rejection (1.0/0.911). CYP3A5 genotypes in both recipient and donor did not affect incidence of infectious complications.
  
  
  CONCLUSIONS
  In the late phase of LDLT patients, the IMK assay is very useful for monitoring immunological aspects including bacterial infection, recurrence of HCV, and rejection.
authors.affiliation: Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
authors.forename: Shugo
authors.initials: S
authors.lastname: Mizuno
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Muraki
authors.forename: Kaname
authors.initials: K
authors.lastname: Nakatani
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanemura
authors.forename: Naohisa
authors.initials: N
authors.lastname: Kuriyama
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ohsawa
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Azumi
authors.forename: Masashi
authors.initials: M
authors.lastname: Kishiwada
authors.forename: Masanobu
authors.initials: M
authors.lastname: Usui
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakurai
authors.forename: Masami
authors.initials: M
authors.lastname: Tabata
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Tomomi
authors.initials: T
authors.lastname: Yamada
authors.forename: Katsuya
authors.initials: K
authors.lastname: Shiraki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nobori
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okuda
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
mesh_terms: D000255:Adenosine Triphosphate / Q000097:blood / Q000378:metabolism*; D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism*; D051544:Cytochrome P-450 CYP3A / Q000235:genetics / Q000378:metabolism; D005260:Female; D005838:Genotype; D006084:Graft Rejection / Q000276:immunology / Q000378:metabolism / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D007239:Infections / Q000378:metabolism / Q000382:microbiology / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016559:Tacrolimus / Q000008:administration & dosage / Q000493:pharmacokinetics; D014181:Transplantation Immunology; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D000255:Adenosine Triphosphate; C510164:CYP3A5 protein, human; D051544:Cytochrome P-450 CYP3A; D016559:Tacrolimus