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DONOR-SPECIFIC IFN-[GAMMA] PRODUCING LYMPHOCYTES PROFILE IN HEPATITIS+ LIVER RECIPIENTS.
Anat R. Tambur, DMD, PhD , Ziv Ben-Ari MD , Nancy D. Herrera , Peter Heeger MD , Tirza Klein PhD , Rachel Micowitz and Eytan Mor MD . Chicago IL, Rush Med Ctr, 60612, Pathology ; Petach Tiqva Israel, Rabin Med Ctr, Transplantation and Cleveland OH, Cleveland Clinic, Transplantation .
Background: The ability to monitor the immunologic status of allograft recipients towards their transplanted organ is crucial for judicious individualization of immunosuppression.
Patients: Fifteen liver transplant recipients were followed for 6-24 months post transplantation. PBL were obtained from consented recipients at specific intervals pre- and post-transplant; and from donors at organ harvest. IFN-γ secretion was measured using an ELISPOT assay; ATP consumption was assayed using the Cylex kit; and donor specific HLA antibodies were measured using the TMS assay (GTI).
Results: Three patterns of responses were observed. Group I: Five patients had low IFN-γ response to their donor throughout the follow-up. Group II: Five patients produced similar, or higher, levels of IFN-γ in response to their donor versus allogeneic pool. Group III: Three patients had fluctuating responses to their donor and allogeneic pool.
Conclusions:While it is still premature to make clinical-relevant conclusions, intriguing correlation was found between hepatitis recurrence and IFN-γ secretion. In Group I - 4/5 patients had hepatitis prior to transplant that recurred early post-transplant. Conversely, in Group II, 4/5 patients had hepatitis prior to transplantation, but only 1/4 recurred. Additionally, we demonstrated that the ability of patients to secrete IFN-γ in-vitro is not correlated with immunosuppression levels. We therefore propose that the ability of recipients to secrete IFN-γ in response to donor/allogeneic pool, as seen in-vitro, is also not affected by immunosuppressive protocols. Hence, analyzing levels of donor-specific IFN-γ producing-lymphocytes may serve as a monitoring tool of the immune-status in liver recipient.