Lin Y-X, Yan L-N, Li B, Wang L-L, Wen T-F, Zeng Y, Wang W-T, Zhao J-C, Yang J-Y, Xu M-Q, Ma Y-K, Chen Z-Y, Bai Y-J
The Center of Liver Transplantation, Department of Surgery, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
Transplant Proc. 2009 Dec;41(10):4229-31. doi: 10.1016/j.transproceed.2009.09.072.
The appearance of human regulatory CD8(+) CD28(-) T-suppressor (Ts) cells has been associated with a reduced need for maintenance immunosuppression in cadaveric heart- kidney transplant recipients and pediatric liver-intestine transplant recipients. However, few data are available in adult-to-adult living donor liver transplantation (A-A LDLT).
To study the population of CD8(+) CD28(-) Ts cells in A-A LDLT, we performed flow cytometry on whole blood specimens obtained from 20 transplant recipients, 18 end-stage liver disease patients, and 20 normal controls. Meanwhile, we measured the trough levels of immunosuppressants and monitored graft function in transplant recipients. We retrospectively reviewed the clinical data of the 20 recipients.
A significant expansion of CD8(+) CD28(-) Ts cells was observed among recipients of A-A LDLT as compared with a disease control group (P = .000) or healthy individuals (P = .000). All recipients were free of acute cellular rejection episodes. During the follow-up period, no grafts were lost due to acute or chronic rejection.
Expansion of CD8(+) CD28(-) Ts cells in A-A LDLT seemed to be associated with a decreased occurrence of acute or chronic rejection and sustained good graft function. Based on our low dosages of immunosuppressants for recipients of A-A LDLT, we suggest that this strategy may promote expansion of CD8(+) CD28(-) Ts cells, which can conversely maintain the low immunosuppressant dosages.
人类调节性CD8(+) CD28(-) T抑制细胞（Ts细胞）的出现与尸体心脏-肾脏移植受者及小儿肝-肠移植受者维持免疫抑制需求的降低相关。然而，在成人对成人活体肝移植（A-A LDLT）中，相关数据较少。
为研究A-A LDLT中CD8(+) CD28(-) Ts细胞群体，我们对从20名移植受者、18名终末期肝病患者及20名正常对照者获取的全血标本进行了流式细胞术检测。同时，我们测定了移植受者免疫抑制剂的谷浓度并监测移植物功能。我们回顾性分析了20名受者的临床资料。
与疾病对照组（P = .000）或健康个体（P = .000）相比，A-A LDLT受者中观察到CD8(+) CD28(-) Ts细胞显著扩增。所有受者均未发生急性细胞排斥反应。在随访期间，无移植物因急性或慢性排斥反应而丢失。
A-A LDLT中CD8(+) CD28(-) Ts细胞的扩增似乎与急性或慢性排斥反应发生率降低及移植物功能持续良好相关。基于我们对A-A LDLT受者使用低剂量免疫抑制剂的情况，我们认为该策略可能促进CD8(+) CD28(-) Ts细胞的扩增，而这反过来又可维持低剂量免疫抑制剂的使用。
