| Budget Amount *help |
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 1999: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 1998: ¥2,000,000 (Direct Cost: ¥2,000,000)
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| Research Abstract |
Introduction: The outcome of liver transplants has improved. However, acute rejection is nevertheless a major problem. Fine-needle aspiration biopsy (FNAB) is a very safe and helpful procedure for the diagnosis of acute rejection, achieving a similar diagnostic yield as core liver biopsy in experienced centers. The purpose of this study is to evaluate an immunological state of allografts quantitatively using FNAB samples in comparison with peripheral blood lymphocytes (PBL) by flow cytometric analysis.
Methods: Ten living-related liver allografts for children were monitored with FNAB at 2-3 day intervals and whenever rejection crisis was suspected. Lymphoid cell subpopulations from PBL and aspiration biopsies of allografts by flow cytometry were analyzed.
Results: The expression of CD4CD25, CD8CD25 and CD4DR increased slightly (3-6%) in case of mild to moderate rejection in both samples. However, 1 to 3 days prior to rejection, CD8DR positive cells increased significantly in FNAB samples compared to that in PBL (p<0,05). In severe rejection episodes, not only CD4DR, CD8DR but CD4CD25, CD8CD25 positive cells also increased (20-30%) especially in FNAB samples. These findings correlated well with biochemical laboratory parameters, and the increase of activated lymphocytes (CD4CD25, CD4DR, CD8CD25, CD8DR positive cells) in the grafts could be observed already 2-5 days earlier than elevated serum values indicated liver dysfunction. Furthermore, there was no significant serial change during non-immunological graft damages (I.e. arterial thrombosis or bile leakage).
Conclusion: Flow cytometry study of FNAB samples could be a reliable method to prospect immunological activation in liver allografts (I.e. acute rejection episodes).
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