Stutchfield BM, Bodingbauer MW, Adair A, Wakelin S, Schindl M, Forbes SJ, Wigmore SJ. Quantifying changes in innate immune function following liver transplantation for chronic liver disease.
HPB (Oxford) 2019;
21:1322-1326. [PMID:
30850189 DOI:
10.1016/j.hpb.2019.02.004]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/26/2019] [Accepted: 02/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND
Liver transplantation (LT) offers patients with cirrhosis long-term survival, however many die from sepsis whilst awaiting LT. The liver's role in innate immunity may be key to improving outcomes, but the immune effects of LT have not been quantified.
METHODS
Innate immune capacity was assessed by clearance of 99mTc-Albumin nanospheres in patients with chronic liver failure before and after LT.
RESULTS
Twenty-eight patients with chronic liver disease on the LT waiting list entered the study during the twelve-month study period and nine patients underwent LT and completed the study protocol. One patient developed hepatic artery thrombosis in <7 days and was excluded from the study. Innate immune function was significantly impaired in patients with chronic liver disease on the LT waiting list and this was directly correlated with MELD score. LT normalised innate immune function by day 1 post LT with further improvement occurring by day 7 post LT. Donor liver weight was the only factor correlated with innate immune function at day 1 post LT but this effect was negated by day 7 post LT.
CONCLUSION
Recognising the immune effects of LT may facilitate treatment of cirrhosis and inform development of extracorporeal liver support systems.
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