Quantification of anti-viral cytotoxic T-lymphocytes by tetrameric human leukocyte antigen complexes following living donor liver transplantation.

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Background : Cytomegalovirus(CMV) and Epstein-Barr virus(EBV) infection causes significant morbidity and mortality among transplant recipients. Cytotoxic T-cells(CTL) are the pivotal component to control those viral infections. Tetrameric HLA (so-called tetramers) detect specific CTL against those viruses, and may help analysis of infection.Aim : To compare tetramers of different alleles and antigen peptides.Methods : Sixty recipients of living liver graft were prospectively followed for 2-36 months. All had either of HLA A^*0201 or A^*2402, and corresponding tetramers were used to stain CTL. Viral DNA were monitored by real-time PCR.Results : A^*0201 CMV pp65 tetramer stained CTL more efficiently than A^*2402 CMV pp65 tetramer, even though the frequency of CMV infection was similar in both of A^*0201 group and A^*2402. Similar results were obtained for EBV.Interpretation : Tetrameric HLA detects only a part of whole anti-viral CTL, which makes it difficult to assume that the absence of tetramer-reacting CTL might imply a lack of whole anti-viral CTL. A^*0201 CMV pp65 tetramer alone seemed promising for monitoring anti-viral CTL.