Impact of Preexisting Circulating Effector T cells on the Outcome of ABO-Incompatible Adult LDLT

Egawa, Hiroto; Ozawa, Kazue; Takada, Yasutsugu; Teramukai, Satoshi; Mori, Akira; Kasahara, Mureo; Ogawa, Kohei; Ogura, Yasuhiro; Oike, Fumitaka; Kaido, Toshimi; Ono, Masako; Sato, Hiroshi; Takai, Kenji; Uemoto, Shinji

Our aim was to clarify the significance of phenotype of circulating CD8 T(+) cells on the outcome of ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). Twenty-six recipients undergoing ABO-I LDLT and 92 undergoing ABO-compatible (ABO-C) LDLT were classified into three groups according to preoperative proportion of CD8 T(+) cells: naive-dominant (group I), effector memory-dominant (group II), and effector-dominant (group III) recipients. The clinical courses were analyzed. The results showed that in ABO-C groups I and II and in ABO-I group I, effector cells remained above the pretransplant levels after tacrolimus administration. However, in ABO-C group III and ABO-I groups II and III, effector cells were down-regulated for a prolonged period, along with markedly decreased perforin expression and frequent life-threatening complications. ABO-I group II and group III recipients had higher infection rates. It was concluded that recipients with preexisting high effector CD8 T(+) cells are unfavorable candidates for ABO-I LDLT.