Compromised immune status of patients with post-liver transplant biliary complications

Lei, Hong; Tian, Mingxing; Zhang, Xiaogang; Meng, Liesu; Zhu, Wenhua; Liu, Xuemin; Wang, Meng-Zhou; Wang, Tao; Chang, Peng; Chen, Huan; Wang, Bo; Wu, Rongqian; Lyu, Yi

doi:10.1097/cm9.0000000000001088

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“…Mysore et al have reported that patients with the highest expression of PD-1 + Tim-3 + T cells in the memory compartment before LTx had increased incidence of infections after LTx, especially within the first 90 days [ 13 ]. The evaluation of T cell subsets has played an important role in predicting post-transplant infections and allograft rejections in transplant recipients [ 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Expansion of Double-Negative T Cells in Patients before Liver Transplantation Correlates with Post-Transplant Infections

Lei

Tian

Zhang

et al. 2022

JCM

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Liver transplantation (LTx) is currently the only effective therapy for patients with end-stage liver diseases, but post-transplant infection is a key issue for morbidity and mortality. In this study, we found that pre-transplant patients with an expansion of double-negative T (DNT) cells (CD3+CD4−CD8− T cells) had an increased incidence of infections within the first 6 months after LTx. These DNT cells also negatively correlated with their CD4/CD8 ratio. Compared to patients who had no infections after LTx, these DNT cells expressed more CD25, especially in the memory compartment. The receiver operating characteristic (ROC) analysis showed that the threshold area under the ROC curve of DNT cells which could be used to distinguish LTx patients with post-transplant infections from patients without infections after LTx was 0.8353 (95% CI: 0.6591–1.000). The cut-off for the pre-LTx DNT cell level was 11.35%. Although patients with post-transplant infections had decreased levels of CD4/CD8 T cells, CD8+ T cells in these patients were more exhausted, with higher PD-1 expression and lower IFNγ secretion. The increased levels of DNT cells in patients with post-transplant infections were still observed 2 weeks after LTx, with higher proportions of memory DNT cells. In conclusion, increased levels of DNT cells in pre-LTx patients may be valuable for the prognosis of post-transplant infections, especially within the first 6 months after LTx.

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