Recipient's Killer Cell Immunoglobulin-like Receptor Genotype and Human Leukocyte Antigen C Ligand Influence the Clinical Outcome following Living Donor Liver Transplantation.
10.4174/jkss.2010.78.6.357
- Author:
Say June KIM
1
;
Dong Goo KIM
;
Tai Gyu KIM
;
Hee Baeg CHOI
;
Eun Sun JUNG
Author Information
1. Department of Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, School of Medicine, Daejeon, Korea.
- Publication Type:Original Article
- Keywords:
Killer immunoglobulin-like receptor (KIR);
Human leukocyte antigen (HLA);
Alanine transaminase (ALT);
Living donor liver transplantation (LDLT);
Natural killer cell (NK cell)
- MeSH:
Adult;
Alanine Transaminase;
Genotype;
HLA-C Antigens;
Humans;
Incidence;
Leukocytes;
Lifting;
Ligands;
Liver;
Liver Transplantation;
Living Donors;
Polymerase Chain Reaction;
Receptors, KIR;
Retrospective Studies;
Tissue Donors;
Transplants
- From:Journal of the Korean Surgical Society
2010;78(6):357-368
- CountryRepublic of Korea
- Language:English
-
Abstract:
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) (> or =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.
