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Kidney Int. 2018 Jun;93(6):1465-1474. doi: 10.1016/j.kint.2018.01.022. Epub 2018 Apr 12.

Donor-specific hypo-responsiveness occurs in simultaneous liver-kidney transplant recipients after the first year.

Author information

1
William J. von Liebig Center for Transplantation, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: taner.timucin@mayo.edu.
2
Human Cellular Therapy Laboratory, Mayo Clinic, Rochester, Minnesota, USA.
3
Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA.
4
William J. von Liebig Center for Transplantation, Mayo Clinic, Rochester, Minnesota, USA.
5
William J. von Liebig Center for Transplantation, Mayo Clinic, Rochester, Minnesota, USA; Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA.

Abstract

Kidney allografts of patients who undergo simultaneous liver-kidney transplantation incur less immune-mediated injury, and retain better function compared to other kidney allografts. To characterize the host alloimmune responses in 28 of these patients, we measured the donor-specific alloresponsiveness and phenotypes of peripheral blood cells after the first year. These values were then compared to those of 61 similarly immunosuppressed recipients of a solitary kidney or 31 recipients of liver allografts. Four multicolor, non-overlapping flow cytometry protocols were used to assess the immunophenotypes. Mixed cell cultures with donor or third party cells were used to measure cell proliferation and interferon gamma production. Despite a significant overlap, simultaneous liver-kidney transplant recipients had a lower overall frequency of circulating CD8+, activated CD4+ and effector memory T cells, compared to solitary kidney transplant recipients. Simultaneous liver-kidney transplant recipient T cells had a significantly lower proliferative response to the donor cells compared to solitary kidney recipients (11.9 vs. 42.9%), although their response to third party cells was unaltered. The frequency of interferon gamma producing alloreactive T cells in simultaneous liver-kidney transplant recipients was significantly lower than that of solitary kidney transplant recipients. Flow cytometric analysis of the mixed cultures demonstrated that both alloreactive CD4+ and CD8+ compartments of the simultaneous liver-kidney transplant recipient circulating blood cells were smaller. Thus, the phenotypic and functional characteristics of the circulating blood cells of the simultaneous liver-kidney transplant recipients resembled those of solitary liver transplant recipients, and appear to be associated with donor-specific hypo-alloresponsiveness.

KEYWORDS:

alloimmunity; immunoregulation; kidney transplantation; rejection; simultaneous liver-kidney transplantation

PMID:
29656904
DOI:
10.1016/j.kint.2018.01.022
[Indexed for MEDLINE]

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