title: Mass cytometry reveals a distinct immunoprofile of operational tolerance in pediatric liver transplantation.
abstract: Long-term IS in transplant patients has significant morbidity, poorer quality of life, and substantial economic costs. TOL, defined as graft acceptance without functional impairment in the absence of IS, has been achieved in some pediatric LT recipients. Using mass cytometry, peripheral blood immunotyping was performed to characterize differences between tolerant patients and patients who are stable on single-agent IS. Single-cell mass cytometry was performed using blood samples from a single-center pediatric LT population of operationally tolerant patients to comprehensively characterize the immune cell populations in the tolerant state compared with patients on chronic low-dose IS. Specific T-cell populations of interest were confirmed by flow cytometry. This high-dimensional phenotypic analysis revealed distinct immunoprofiles between transplant populations as well as a CD4+TOT (CD4+CD5+CD25+CD38-/loCD45RA) that correlates with tolerance in pediatric LT recipients. In TOL patients, the TOT was significantly increased as compared to patients stable on low levels of IS. This TOT cell was confirmed by flow cytometry and is distinct from classic Treg cells. These results demonstrate the power of mass cytometry to discover significant immune cell signatures that have diagnostic potential.
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford, CA, USA.|Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors: Audrey H
authors: AH
authors: Lau
authors: Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors: Matthew J
authors: MJ
authors: Vitalone
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford, CA, USA.
authors: Kelly
authors: K
authors: Haas
authors: Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors: Todd
authors: T
authors: Shawler
authors: Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors: Carlos O
authors: CO
authors: Esquivel
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford, CA, USA.
authors: William E
authors: WE
authors: Berquist
authors: Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.|Stanford Immunology, Stanford University School of Medicine, Stanford, CA, USA.
authors: Olivia M
authors: OM
authors: Martinez
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford, CA, USA.
authors: Ricardo O
authors: RO
authors: Castillo
authors: Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.|Stanford Immunology, Stanford University School of Medicine, Stanford, CA, USA.
authors: Sheri M
authors: SM
authors: Krams
mesh_terms: D000293:Adolescent; D002648:Child; D019295:Computational Biology; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007107:Immune System; D007108:Immune Tolerance; D016130:Immunophenotyping; D007963:Leukocytes, Mononuclear / Q000166:cytology; D016031:Liver Transplantation; D008297:Male; D010372:Pediatrics; D010641:Phenotype; D023001:Transplantation Tolerance; D055815:Young Adult
keywords: T cells; cytometry by time of flight; immune cells; peripheral blood mononuclear cells; post-transplant