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Early immunological monitoring after pediatric liver transplantation: Cytokine immune deviation and graft acceptance in 40 recipients
Author(s) -
Gras Jérémie,
Wieërs Grégoire,
Vaerman JeanLuc,
Truong Dinh Quang,
Sokal Etienne,
Otte JeanBernard,
Délépaut Béatrice,
Cornet Anne,
de Ville de Goyet Jean,
Latinne Dominique,
Reding Raymond
Publication year - 2007
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21084
Subject(s) - medicine , liver transplantation , immunosuppression , cytokine , transplantation , biopsy , gastroenterology , context (archaeology) , immune system , immunology , paleontology , biology
Cytokine deviation may be a factor contributing to graft acceptance. We analyze, in the context of liver transplantation, circulating cytokine levels and their mRNA precursors in liver biopsy samples to study a putative correlation with early immunologic outcome. Forty primary pediatric liver recipients were submitted to a prospective immune monitoring protocol, including 8 of 40 patients with an early, biopsy‐proven acute rejection episode. The 32 patients with graft acceptance showed markedly increased interleukin (IL)‐10 blood levels at 2 hours after reperfusion on days 1 and 4 after transplantation as compared with baseline, whereas patients with graft rejection only exhibited increased IL‐10 levels at 2 hours. A good correlation was observed between IL‐10 peripheral levels and levels ascertained by IL‐10 reverse transcriptase–polymerase chain reaction at 2 hours and on day 7. Patients with graft acceptance also showed a decrease in interferon gamma (IFN‐γ) at 1 and 2 hours after reperfusion on days 1, 4, 7, 14, and 28 after transplantation. One patient with graft tolerance who had subsequent immunosuppression withdrawal after posttransplantation lymphoproliferative disease showed a similar intraoperative IL‐10 pattern, whereas posttransplantation tumor necrosis factor alpha and IFN‐γ levels greatly decreased. The occurrence of cytokine immune deviation may therefore be related to early graft acceptance in children who receive liver transplants. Liver Transpl 13:426–433, 2007. © 2007 AASLD.