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Rapid method for the analysis of peripheral chimerism in suspected graft‐versus‐host disease after liver transplantation
Author(s) -
Hahn Amy B.,
Baliga Prabhakar
Publication year - 2000
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.500060214
Subject(s) - microchimerism , medicine , immunology , liver transplantation , population , graft versus host disease , cd8 , transplantation , human leukocyte antigen , immune system , biology , pregnancy , antigen , fetus , genetics , environmental health
The effects of microchimerism and possible tolerance have been well studied in orthotopic liver transplantation. In some patients, greater levels of donor cells persist in the periphery. These cells were characterized and their effects on clinical outcome were studied. Peripheral blood was obtained from patients at various times posttransplantation. HLA class II typing was performed by the polymerase chain reaction–sequence‐specific primer method on unfractionated blood and lymphocyte subpopulations. Relative levels of amplification of donor and recipient alleles were compared. All patients studied had a low degree of chimerism that was most apparent in the CD8 + T/natural killer (NK) cell population. One patient with persistently high levels of donor alleles in his CD8 + T/NK cell population was diagnosed with severe graft‐versus‐host disease (GVHD) and died of opportunistic infections. Another patient with biopsy‐proven GVHD was chimeric in several cell populations. On resolution of her symptoms, donor alleles were reduced to levels undetectable by this assay. These results suggest that persistently elevated levels of donor CD8 + T/NK cells in the periphery may indicate GVHD in liver transplant recipients. This technique aids in rapid diagnosis, which facilitates appropriate treatment and thus may improve clinical outcome.