title: The dynamic and clinical significance of autoantibodies and immunoglobulins in liver transplant recipients.
abstract: Little is known about autoantibody pattern in liver transplantation (LT). The aim of the study was to examine autoantibodies (AAB) and immunoglobulins in patients with end-stage liver disease before and after LT. Patients with LT who underwent post-LT biopsies between 10/2008 and 8/2011 were enrolled. AAB were assessed at the time of LT and liver biopsy. Demographics, serum immunoglobulins, AAB, and liver histology (explant, post-LT biopsies) were analyzed. Two hundred and twenty patients (M/F 143/77; age at LT 54 (19-73)) were included; AAB and immunoglobulins were evaluated in 76 patients. Length of follow-up from LT was 285 (30-1462) days. Sixty-one percent of patients had hepatitis C (HCV); 83% developed recurrent HCV. A significant decrease in IgG, IgA, IgM (p < 0.001 each), anticardiolipin antibodies IgG and IgM (p = 0.02), and beta-2 microglobulin (p = 0.004) was observed post-LT. HCV patients had higher IgG (p = 0.005), rheumatoid factor (p = 0.044) before LT; elevated IgM was associated with increased inflammation in the explant (p = 0.007). Lower IgG levels and antismooth muscle antibodies were present before LT in a higher percentage in patients who would develop recurrent HCV (p = 0.004, p = 0.077, respectively). In conclusion, AAB change significantly after LT and have a different pattern in HCV. Some immunological markers are associated with HCV recurrence and advanced inflammation on explant.
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Stanca
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Costica
authors.initials: C
authors.lastname: Aloman
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Fiel
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Kaiser
authors.initials: K
authors.lastname: Raja
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Oguz
authors.initials: O
authors.lastname: Uskudar
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Sander
authors.initials: S
authors.lastname: Florman
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Schiano
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D018450:Disease Progression; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis* / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007136:Immunoglobulins / Q000097:blood* / Q000276:immunology; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D007136:Immunoglobulins
keywords: autoantibodies; hepatitis C; immunoglobulins; liver transplantation