Individualized Immunosuppressive Protocol of Liver Transplant Recipient Should be Made Based on Splenic Function Status  

作　　者：Ji-Yong Song Guo-Sheng Du Li Xiao Wen Chen Long-Long Suo Yu Gao Li-Kui Feng Bing-Yi Shi 

机构地区：[1]Department of Education, Chinese People's Liberation Army Medical School, Beijing 100853, China [2]Department of Hepatobiliary, Organ Transplant Institute, The 309th Hospital of Chinese People's Liberation Army, Beijing 100091, China

出　　处：《Chinese Medical Journal》2016年第11期1340-1346,共7页中华医学杂志（英文版）

摘　　要：Background： Lymphocyte subsets play important roles in rejection in liver transplant recipients, and the effect of splenic function on these roles remains unknown. The aim of this study was to explore the feasibility to adjust immunosuppressive agents based on splenic function status through detecting the lymphocyte subsets in liver transplant recipients. Methods： The lymphocyte subsets of 49 liver transplant recipients were assessed in the 309th Hospital of Chinese People＇s Liberation Army between June 2014 and August 2015. The patients were divided into splenectomy group （n - 9）, normal splenic function group （n = 24）, and hypersplenism group （n = 16）. The percentages and counts of CD4＋ T, CD8＋ T, natural killer （NK） cell, B-cell, regulatory B-cell （Breg）, and regulatory T-cell （Treg） were detected by flow cytometer. In addition, the immunosuppressive agents, histories of rejection and infection, and postoperative time of the patients were compared among the three groups. Results： There was no significant difference of clinical characteristics among the three groups. The percentage ofCD 19＋CD24＋CD38＋ Breg was significantly higher in hypersplenism group than normal splenic function group and splenectomy group （3.29±0.97% vs. 2.12 i 1.08% and 1.90 ± 0.99%, P = 0.001）. The same result was found in CD4＋CD25＋FoxP3＋ Treg percentage （0.97 ± 0.39% vs. 0.54 ±0.31% and 0.56 ± 0.28%, P = 0.001 ）. The counts of CD8＋ T-cell, CD4＋ T-cell, and NK cell were significantly lower in hypersplenism group than normal splenic function group （254.25 ± 149.08 vs. 476.96 ± 225.52, P = 0.002; 301.69 ±154.39 vs. 532.50 ±194.42, P= 0.000; and 88.56± 63.15 vs. 188.33± 134.51, P = 0.048）. Moreover, the counts of CD4＋ T-cell and NK cell were significantly lower in hypersplenism group than splenectomy group （301.69 ± 154.39 vs. 491.89 ± 132.31, P = 0.033; and 88.56 ± 63.15 vs. 226.00± 168.85, P 0.032）. Conclusion： Splenic function status might affect the immBackground： Lymphocyte subsets play important roles in rejection in liver transplant recipients, and the effect of splenic function on these roles remains unknown. The aim of this study was to explore the feasibility to adjust immunosuppressive agents based on splenic function status through detecting the lymphocyte subsets in liver transplant recipients. Methods： The lymphocyte subsets of 49 liver transplant recipients were assessed in the 309th Hospital of Chinese People＇s Liberation Army between June 2014 and August 2015. The patients were divided into splenectomy group （n - 9）, normal splenic function group （n = 24）, and hypersplenism group （n = 16）. The percentages and counts of CD4＋ T, CD8＋ T, natural killer （NK） cell, B-cell, regulatory B-cell （Breg）, and regulatory T-cell （Treg） were detected by flow cytometer. In addition, the immunosuppressive agents, histories of rejection and infection, and postoperative time of the patients were compared among the three groups. Results： There was no significant difference of clinical characteristics among the three groups. The percentage ofCD 19＋CD24＋CD38＋ Breg was significantly higher in hypersplenism group than normal splenic function group and splenectomy group （3.29±0.97% vs. 2.12 i 1.08% and 1.90 ± 0.99%, P = 0.001）. The same result was found in CD4＋CD25＋FoxP3＋ Treg percentage （0.97 ± 0.39% vs. 0.54 ±0.31% and 0.56 ± 0.28%, P = 0.001 ）. The counts of CD8＋ T-cell, CD4＋ T-cell, and NK cell were significantly lower in hypersplenism group than normal splenic function group （254.25 ± 149.08 vs. 476.96 ± 225.52, P = 0.002; 301.69 ±154.39 vs. 532.50 ±194.42, P= 0.000; and 88.56± 63.15 vs. 188.33± 134.51, P = 0.048）. Moreover, the counts of CD4＋ T-cell and NK cell were significantly lower in hypersplenism group than splenectomy group （301.69 ± 154.39 vs. 491.89 ± 132.31, P = 0.033; and 88.56 ± 63.15 vs. 226.00± 168.85, P 0.032）. Conclusion： Splenic function status might affect the imm

关 键 词：HYPERSPLENISM Liver Transplantation Lymphocyte Subsets SIROLIMUS 

分 类 号：S852.4[农业科学—基础兽医学] TQ460.38[农业科学—兽医学]