Immunological assessment of peripheral lymphocytes of patientsafter living related liver transplantation

点击翻译按钮获取中文摘要

We have reduced immunosuppression of patients with stable and normal liver function after living related liver transplantation (LRLT). For immunological analysis in patients after LRLT, we measured Th1 cytokines (IL-2, IFN) in the effluent of mixed lymphocyte reaction (MLR) against lymphocytes of donors or third party persons.1)MLR patients before transplantation.The mean values of IL-2 and IFN in the effluent in MLR against donors ( 3.8 pg/ml and 24.1 pg/ml, respectively) were significantly lower than those against third party (27.5 pg/ml, 88.2 pg/ml, respectively). This hyporesponsiveness against related donors prior to transplantation presumably due to HLA haploidentical combination could be an advantage of LRLT compared to cadaveric transplantation.2)MLR in patients with stable and normal liver functions under immunosuppression longer than 2 years after transplantation.The effluent levels of IL-2 and IFN in patients with smaller doses of immunosuppression were greater than those in patients with larger doses. Further, the hyporesponsiveness against donors compared to the third party were remained in these patients. It is suggested that immunosuppression can be reduced as far as the liver functions are stable and the cytokine levels in the MLR effluent are high. Currently, a protocol of prospective reduction of immunosuppression is successfully carried out based on this findings.3)MLR in 7 patients with stable and normal liver functions with no immunosuppression.The cytokine levels in the effluent of MLR against donors are similar to those against third party. It is suggested that the peripheral lymphocytes of the patients in clinical tolerance do not acquired tolerance to donor. Further study focusing on the immunoreaction in the accepted organs including expression of HLA antigens is required to clarify the mechanism of the tolerance.