| Project/Area Number |
09357011
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| Research Category |
Grant-in-Aid for Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Section | 展開研究 |
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| Research Field |
General surgery
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| Research Institution | KYOTO UNIVERSITY |
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Principal Investigator |
TANAKA Koichi Kyoto University, Dpt.of Transplantation and Immunology, Professor, 医学研究科, 教授 (20115877)
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| Co-Investigator(Kenkyū-buntansha) |
TAKAKURA Kouji Medicinal Biology Research Laboratories Fujisawa Pharmaceutical CO., LTD.Researc, 薬理学 開発第一研究所, 研究員
ASONUMA Katsuhiro Kyoto University, Dpt.of Transplantation Immunology, Assistant, 医学研究科, 助手 (40202626)
UEMOTO Shinji Kyoto University, Dpt.of Transplantation Immunology, Assistant, 医学研究科, 助手 (40252449)
INOMATA Yukihiro Kyoto University, Dpt.of Transplantation Immunology, Associate Professor, 医学研究科, 助教授 (50193628)
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| Project Period (FY) |
1997 – 1998
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| Keywords | Living donor liver transplantation / Flowcytometry / Crossmatch / T cell / B cells / Acute rejection / Presensitization / HLA |
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| Research Abstract |
The study investigated clinical relevance of anti-donor antibody in living donor livertransplantation by flowcytometry crossmatch using peripheral blood lymphocytes (T-/B-FCXM) from living donors.
Pretransplant T-FCXM was positive in 8.5% of cases, of which 40% experienced acute rejection within one month (vs. 15% with negative Pretransplant T-FCXM ; NS) without any influence on graft prognosis. Acute rejection with positive pretransplant T-FCXM occurred earlier (8 days vs. 17 days) and needed more steroids. On the other hand, cases with positive posttransplant T-FCXM (20.7%) experienced concomitant or following acute rejection. IgM was detected in all positive T-FCXM and IgG appeared in 41.7% with chronological class switching. Though anti-donor antibody was confined to acute rejection episodes, it was not detected in acute rejection in ABO-incompatible cases. Positive T-FCXM rate in acute rejection later than 3 months was much lower than that in early acute rejection within one month.
These results demonstrated the involvement of humoral immunity in early acute rejection after clinical liver transplantation and suggest that background and mechanism of acute rejection vary in the different period after liver transplantation, despite apparently similar chemical and histological changes. Positive T-FCXM sera showed positivity also for lymphocytes from several third parties with diverse HLA types, suggesting the presence of HLA-nonspecific public antibodies.
B-FCXM in the present system showed no significant clinical relevance, provably due to non-specific reaction by constitutional globulin on B cells.
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