Gugenheim J, Canon C, Samuel D, Saliba F, Debotte G, Misset J L, Mathe G, Bismuth H
Groupe de Recherche de Chirurgie Hépatique, Hôpital Paul Brousse, Villejuif.
Nephrologie. 1987;8(3):99-101.
A precise immunological surveillance of liver graft recipients can allow the adaptation to each patient of an adequate immuno-suppressive treatment. In 11 liver-transplanted patients (7 primitive biliary cirrhoses, 2 post-hepatic cirrhoses, one bile duct atresia with one antitrypsin deficit) different lymphocyte subpopulations were tested before transplantation and at days 3, 5, 7, 15, 30, 60 and 120 after grafting using OKT3, OKT4, OKT8 (Orthoclone, France). In 6 patients presenting one or more rejections, the (T4+):(T8+) lymphocyte ratio was significantly increased during the days preceding rejection. In all cases, the (T4+):(T8+) ratio increase was linked to a (T4+) helper lymphocyte augmentation. In the 6 patients who did not present any rejection, the (T4+):(T8+) ratio did not increase at long term. A decrease of the (T4+):(T8+) ratio, along with an augmentation of (T8+) lymphocytes, was noticed at long term in patients free of chronic rejection. The evolution of T lymphocyte populations, followed using monoclonal antibodies and mainly the (T4+):(T8+) ratio, can provide a test for rejection predictability of for the prognosis of tolerance to liver allografts.
对肝移植受者进行精确的免疫监测,可为每个患者量身定制适当的免疫抑制治疗方案。在11例肝移植患者中(7例原发性胆汁性肝硬化、2例肝后性肝硬化、1例胆管闭锁合并α1抗胰蛋白酶缺乏症),在移植前以及移植后第3、5、7、15、30、60和120天,使用OKT3、OKT4、OKT8(法国Orthoclone公司产品)检测不同的淋巴细胞亚群。在6例出现一次或多次排斥反应的患者中,排斥反应发生前几天,(T4+):(T8+)淋巴细胞比值显著升高。在所有病例中,(T4+):(T8+)比值升高与(T4+)辅助性淋巴细胞增多有关。在6例未出现任何排斥反应的患者中,(T4+):(T8+)比值长期未升高。在无慢性排斥反应的患者中,长期观察到(T4+):(T8+)比值降低,同时(T8+)淋巴细胞增多。使用单克隆抗体监测T淋巴细胞群体的变化,主要是(T4+):(T8+)比值的变化,可为肝移植排斥反应的预测或移植耐受预后提供一项检测指标。