Effect of Liver Transplantation on Tuftsin Activity and Phagocytic Activity of Neutrophil Granulocytes in Patients with Liver Cirrhosis

Abstract

Background: Tuftsin activity (TA) is reduced in cirrhosis. This contributes to the defective phagocytic activity (PA) of neutrophil granulocytes and is related to the impairment of splenic function. Orthotopic liver transplantation (OLT) cures cirrhosis and might restore TA. This study was aimed at determining if OLT restores TA and PA. Methods: We measured in 9 cirrhotic patients, before and after successful OLT, TA by a bioassay and PA by chemiluminescence in which neutrophils of the patient were tested with both autologous (PA1) and pooled sera from healthy subjects (PA2). Splenic function was assayed by the pitted red cell count. Results: Before OLT, TA was reduced in 7 patients, and PA1 in all the patients. Pitted cell count was elevated in all the patients. After OLT (median 39 months; range 21–49), TA improved in all cases [median: from 8% (5–16%) to 20% (9–22%), p < 0.008], normalizing in 5 out of the 7 patients with low values. PA1 improved in all the patients [from 102 cpm (65–128 cpm) to 235 cpm (78–280 cpm), p < 0.008], normalizing in 5. Pitted red count decreased in 7 patients and normalized in 3 [from 3.3% (2.1–6.0%) to 2.4% (1.4–2.8%), p < 0.021]. Platelet count [from 55 × 10³ (30–100) to 185 × 10³ (93–286), p < 0.008] and leucocyte count [from 3.60 × 10³ (1.81–5.23) to 5.53 × 10³ (3.31–6.71), p < 0.008] also improved. Conclusions: OLT improves TA and PA of cirrhotic patients. This effect is associated with an improvement of both functional hyposplenism and haematological hypersplenism. The restoration of natural defences against infections may mitigate the adverse effect of immunosuppressive treatment.

Störungen des angeborenen Immunsystems bei akuten und chronischen Lebererkrankungen

“…Although immunosuppression is necessary after transplantation, there is evidence that liver transplantation improves neutrophil function [153].…”

Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis

“…Furthermore, only a minority of the patients in this study had functional hyposplenism (as defined by pitted erythrocytes > 15%) [ 27 ]. Interestingly, resolution of functional hyposplenism was reported in a small cohort of cirrhotic patients after liver transplantation [ 28 ]. Therefore, we hypothesize that functional hyposplenism is not only related to the underlying liver disease but the presence of cirrhosis and portal hypertension itself.…”