Immune response following liver transplantation compared to kidney transplantation: usefulness of monitoring peripheral blood CD4+ adenosine triphosphate activity and cytochrome P450 3A5 genotype assay.
Seventy living donor liver transplantation (LDLT) and 39 kidney transplantation (KT) patients were randomly screened by using the peripheral blood CD4+ adenosine triphosphate activity (ATP) assay (IMK assay). The patients were divided into 2 groups in each organ transplantation with low IMK ATP level (<225 ng/mL) or high (>225) (LT-L: n = 23, KT-L: n = 19, LT-H: n = 47, and KT-H: n = 20, resp.). The incidence of bacterial and/or viral infection was significantly higher in LT-L group than in LT-H group (74.0 versus 8.5%: P < 0.001). Occurrence of total viral infection in KT-L was also significantly higher than that in KT-H (36.8 versus 10%: P = 0.046). The sensitivity and specificity of the IMK assay for identifying risk of infection was 0.810 and 0.878 in LDLT patients and 0.727 and 0.607 in KT patients. The percentage of LDLT patients with cytochrome P450 3A5 (CYP3A5) *1/*1 or *1/*3 genotype (expressors) was significantly higher in LT-L group than in LT-H group (53.8 versus 20.7%: P = 0.032). In both LDLT and KT patients, the IMK assay can be useful for monitoring immunological aspects of bacterial and/or viral infection. CYP3A5 expressors in LT-L group are related to postoperative infections.
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Yu
Y
Nobuoka
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Shugo
S
Mizuno
Divisions of Nephro-Urologic Surgery and Andrology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Kouhei
K
Nishikawa
Department of Molecular and Laboratory Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Kaname
K
Nakatani
Department of Pharmacy, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Yuichi
Y
Muraki
Translational Medical Science, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Tomomi
T
Yamada
Department of Pharmacy, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Masahiro
M
Okuda
Department of Molecular and Laboratory Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Tsutomu
T
Nobori
Divisions of Nephro-Urologic Surgery and Andrology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Yoshiki
Y
Sugimura
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan.
Shuji
S
Isaji
D000255:Adenosine Triphosphate / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D051544:Cytochrome P-450 CYP3A / Q000235:genetics; D005260:Female; D005838:Genotype; D060005:Genotyping Techniques; D006084:Graft Rejection / Q000276:immunology / Q000378:metabolism / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D007223:Infant; D007239:Infections / Q000276:immunology / Q000378:metabolism; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000493:pharmacokinetics / Q000627:therapeutic use; D055815:Young Adult
D007166:Immunosuppressive Agents; D000255:Adenosine Triphosphate; C510164:CYP3A5 protein, human; D051544:Cytochrome P-450 CYP3A; D016559:Tacrolimus