Recipient's Killer Cell Immunoglobulin-like Receptor Genotype and Human Leukocyte Antigen C Ligand Influence the Clinical Outcome following Living Donor Liver Transplantation

Say-June Kim; Dong-Goo Kim; Tai-Gyu Kim; Hee-Baeg Choi; Eun-Sun Jung

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자료유형: 학술저널

저자정보: Say-June Kim (서울성모병원) Dong-Goo Kim (서울성모병원) Tai-Gyu Kim (서울성모병원) Hee-Baeg Choi (서울성모병원) Eun-Sun Jung (서울성모병원)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research 대한외과학회지 Vol.78 No.6

발행연도: 2010.6

수록면: 357 - 368 (12page)

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Purpose: The design of this study was to determine the most influential factor(s) on post-transplant immunological consequences, particularly with regard to the role of killer cell immunoglobulin-like receptors (KIRs) and their ligands (type Ⅰ human leukocyte antigen (HLA)) in unstable liver function.
Methods: Retrospectively collected data from 319 recipients undergoing adult living donor liver transplantation (LDLT) using a right lobe graft between January 2002 and August 2008 were analyzed. Patients were categorized according to the serum alanine transaminase (ALT) pattern; stable ALT pattern was defined as ALT pattern during 3 months post-transplantation, except for initial 2 weeks post-transplantation, in which 2 times or less additional elevation(s) of serum alanine transaminase (ALT) (≥80 IU/L) were observed. When a serum ALT pattern showed fluctuating and/or unpredictable nature, it was defined as an unstable pattern. In addition, genetic information of KIRs and HLA-C allotypes received from 68 recipients and 59 donors was analyzed by way of polymerase chain reaction using sequence-specific primers (PCR-SSP) to determine the factor(s) influencing a serum ALT pattern.
Results: Among 319 LDLT recipients included in this study, the actual incidences of AR and unstable ALT pattern were 13.4% (43/319) and 42.3% (135/319), respectively. Unstable ALT pattern correlated with poorer survival following LDLT than stable pattern (P＜0.000). Genetically, unstable ALT pattern was related to recipients carrying KIR2DL2(＋)/KIR2DS2(＋) combined with the heterogeneous HLA-C allotype (HLA-C1/C2), (relative risks 45.0, 95% confidence interval 2.160∼937.321; P=0.013).
Conclusion: This study indicates that, when performing LDLT, pretransplant determination of recipient’s KIRs and HLA-C allotypes may be beneficial in coping with post-transplant immunological circumstances.

#Killer immunoglobulin-like receptor(KIR) #Human leukocyte antigen(HLA) #Alanine transaminase(ALT) #Living donor liver transplantation(LDLT) #Natural killer cell(NK cell)

참고문헌 (30)

참고문헌 신청

1. [학술지(정기간행물)] - Mazariegos GV / 1997 / Weaning of immunosuppression in liver transplant recipients / Transplantation 63 : 243 ~ 249

2. [학술지(정기간행물)] - Sandborn WJ / 1994 / Cyclosporine withdrawal for nephrotoxicity in liver transplant recipients does not result in sustained improvement in kidney function and causes cellular and ductopenic rejection / Hepatology 19 : 925 ~ 932

3. [학술지(정기간행물)] - Golling M / 1997 / Cyclosporine A reduction and withdrawal in liver transplantation: a risk-benefit analysis / Transplant Proc 29 : 2819 ~ 2821

4. [학술지(정기간행물)] - Devlin J / 1998 / Defining the outcome of immunosuppression withdrawal after liver transplantation / Hepatology 27 : 926 ~ 933

5. [학술지(정기간행물)] - Takatsuki M / 2001 / Weaning of immunosuppression in living donor liver transplant recipients / Transplantation 72 : 449 ~ 454

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