Egawa Hiroto, Ozawa Kazue, Takada Yasutsugu, Teramukai Satoshi, Mori Akira, Kasahara Mureo, Ogawa Kohei, Ogura Yasuhiro, Oike Fumitaka, Kaido Toshimi, Ono Masako, Sato Hiroshi, Takai Kenji, Uemoto Shinji
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan.
Dig Dis Sci. 2009 Oct;54(10):2253-63. doi: 10.1007/s10620-008-0618-y. Epub 2008 Dec 11.
Our aim was to clarify the significance of phenotype of circulating CD8 T(+) cells on the outcome of ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). Twenty-six recipients undergoing ABO-I LDLT and 92 undergoing ABO-compatible (ABO-C) LDLT were classified into three groups according to preoperative proportion of CD8 T(+) cells: naive-dominant (group I), effector memory-dominant (group II), and effector-dominant (group III) recipients. The clinical courses were analyzed. The results showed that in ABO-C groups I and II and in ABO-I group I, effector cells remained above the pretransplant levels after tacrolimus administration. However, in ABO-C group III and ABO-I groups II and III, effector cells were down-regulated for a prolonged period, along with markedly decreased perforin expression and frequent life-threatening complications. ABO-I group II and group III recipients had higher infection rates. It was concluded that recipients with preexisting high effector CD8 T(+) cells are unfavorable candidates for ABO-I LDLT.
我们的目的是阐明循环CD8 T(+)细胞表型对ABO血型不相容（ABO-I）活体供肝移植（LDLT）预后的意义。26例接受ABO-I LDLT的受者和92例接受ABO血型相容（ABO-C）LDLT的受者，根据术前CD8 T(+)细胞比例分为三组：初始型为主（I组）、效应记忆型为主（II组）和效应型为主（III组）受者。分析其临床病程。结果显示，在ABO-C I组和II组以及ABO-I I组中，给予他克莫司后效应细胞仍高于移植前水平。然而，在ABO-C III组以及ABO-I II组和III组中，效应细胞长期下调，同时穿孔素表达明显降低，且频繁出现危及生命的并发症。ABO-I II组和III组受者感染率较高。得出的结论是，预先存在高效应性CD8 T(+)细胞的受者不是ABO-I LDLT的合适候选者。
