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.
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