Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India.
Department of Hepatobiliary and Liver Transplant Surgery, Institute of Liver and Biliary Sciences, New Delhi, India.
Clin Transplant. 2018 Mar;32(3):e13197. doi: 10.1111/ctr.13197. Epub 2018 Feb 8.
To evaluate the effect of donor liver resident mesenchymal cells, M2 macrophages on liver graft outcome after living donor liver transplantation.
Seventy donor biopsies were included in the study. Outcomes at day 3, 7, 30, and 180 postliver transplantation were assessed. Mesenchymal stem cells and M2 macrophages in donor liver biopsies were evaluated.
Mean age of recipients was 40.9 ± 13.6 years. Sex mismatched transplants were 44 (M→F = 9; F→M = 35). On area under receiver operative curve analysis, donor biopsy (DB) nestin ≥3 and CD 163 ≥ 32/200x at day 3; CD163 ≥ 32 at day 7; CD 163 > 32, pRBC of <6.5 units at day 30, and DB nestin ≥3, CD 163 ≥ 32 and pRBC<6.5 units at day 180 predicted adequate graft functions. On multivariate analysis, higher DB nestin (P = .009) and lower cryoprecipitate (P = .009) usage at day 3, higher DB CD163 (P = .006) at day 7, higher DB CD163 (P = .018) and reduced transfusion of packed cell (pRBC) (P = .014) at day 30 and higher DB nestin (P = .011), higher CD163 (P = .009), and reduced pRBC (P = .045) at day 180 were the predictors of better outcome.
Donor liver biopsy nestin+ and CD163+ can predict early graft outcome in living donor liver transplantation.
评估供体肝脏驻留间充质细胞、M2 巨噬细胞对活体肝移植后肝移植物预后的影响。
本研究纳入 70 例供肝活检。评估肝移植后第 3、7、30 和 180 天的结局。评估供肝活检中的间充质干细胞和 M2 巨噬细胞。
受者的平均年龄为 40.9±13.6 岁。男女受者比例为 44（男→女=9；女→男=35）。在受试者工作特征曲线分析中，第 3 天供肝活检（DB）巢蛋白≥3 且 CD163≥32/200x；第 7 天 CD163≥32；第 30 天 CD163>32、pRBC<6.5 单位，第 180 天 DB 巢蛋白≥3、CD163≥32 和 pRBC<6.5 单位预测移植物功能良好。多变量分析显示，第 3 天 DB 巢蛋白较高（P=0.009）和冷沉淀使用较少（P=0.009），第 7 天 DB CD163 较高（P=0.006），第 30 天 DB CD163 较高（P=0.018）和红细胞（pRBC）输注减少（P=0.014），第 180 天 DB 巢蛋白较高（P=0.011）、CD163 较高（P=0.009）和 pRBC 减少（P=0.045）是较好结局的预测因子。
供肝活检巢蛋白+和 CD163+可预测活体肝移植后早期移植物结局。
