Early immunological monitoring after pediatric liver transplantation: Cytokine immune deviation and graft acceptance in 40 recipients

✍ Scribed by Jérémie Gras; Grégoire Wieërs; Jean-Luc Vaerman; Dinh Quang Truong; Etienne Sokal; Jean-Bernard Otte; Béatrice Délépaut; Anne Cornet; Jean de Ville de Goyet; Dominique Latinne; Raymond Reding

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 153 KB
• Volume: 13
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.21084

✦ Synopsis

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-␥) 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-␥ levels greatly decreased. The occurrence of cytokine immune deviation may therefore be related to early graft acceptance in children who receive liver transplants.