Liver Perfusate Natural Killer Cells From Deceased Brain Donors and Association With Acute Cellular Rejection After Liver Transplantation: A Time-to-Rejection Analysis

Abstract

LP cytofluorimetric phenotyping may contribute as a targeted preoperative tool to predict the risk of ACR, and as clinical test in translational studies that aim to improve donor allograft procurement and transplant outcomes.

The Effect of Normothermic Machine Perfusion on the Immune Profile of Donor Liver

“…The liver contains high numbers of lymphohematopoietic cells that are transferred with donor livers to recipients during transplantation ( 10 , 11 ). These donor leukocytes persist in the allograft following transplantation and have been shown to be important determinant of outcome ( 12 ). Using cell therapy or pharmacological treatment of allografts during NMP, the intrinsic immune function of donor livers could be manipulated to optimize organ survival, minimize primary graft dysfunction and offset rejection ( 8 ).…”

Natural killer cells in liver transplantation: Can we harness the power of the immune checkpoint to promote tolerance?

“…The majority of these NK cells expressed activating markers, including NKG2D. 53 Of 46 donor liver perfusates analyzed, 11 recipients experienced an episode of acute cellular rejection. The patients who experienced acute cellular rejection showed a significantly lower percentage of NK cells in the liver perfusate (35% NK cells for non‐rejectors and 28% for rejectors).…”

“…Having a smaller donor liver NK cell population could translate as decreased capability of donor NK cells to prevent recipient immune response against the graft, thus increasing the likelihood of recipient rejection of the allograft. 53 …”

“…Having a smaller donor liver NK cell population could translate as decreased capability of donor NK cells to prevent recipient immune response against the graft, thus increasing the likelihood of recipient rejection of the allograft. 53 When considering NK cell activity in promoting graft tolerance versus rejection, one must consider the role of circulating recipient NK cells. Following graft transplant and restoration of blood flow through the graft, recipient NK cells are detected in the graft within hours.…”

“…Adding to these ideas, Pagano and colleagues found that NK cells (based on a CD3 − CD56 + cell population) made up approximately one third of lymphocytes in the liver perfusate of deceased donors. The majority of these NK cells expressed activating markers, including NKG2D 53 . Of 46 donor liver perfusates analyzed, 11 recipients experienced an episode of acute cellular rejection.…”