Quantifying changes in innate immune function following liver transplantation for chronic liver disease

Abstract

Background: Liver transplantation (LT) offers patients with cirrhosis long-term survival, however many die from sepsis whilst awaiting LT. The liver's role in innate immunity may be key to improving outcomes, but the immune effects of LT have not been quantified.Methods: Innate immune capacity was assessed by clearance of 99m Tc-Albumin nanospheres in patients with chronic liver failure before and after LT.Results: Twenty-eight patients with chronic liver disease on the LT waiting list entered the study during the twelve-month study period and nine patients underwent LT and completed the study protocol. One patient developed hepatic artery thrombosis in <7 days and was excluded from the study. Innate immune function was significantly impaired in patients with chronic liver disease on the LT waiting list and this was directly correlated with MELD score. LT normalised innate immune function by day 1 post LT with further improvement occurring by day 7 post LT. Donor liver weight was the only factor correlated with innate immune function at day 1 post LT but this effect was negated by day 7 post LT. Conclusion:Recognising the immune effects of LT may facilitate treatment of cirrhosis and inform development of extracorporeal liver support systems.

Individualized management of immunosuppressants in liver transplant recipients by using a novel immune score system

“…Next, we found the immunity was greatly impaired in liver transplant recipients before surgery, especially in patients with benign diseases. Innate and adaptive immune dysfunctions are significantly compromised in patients with chronic liver disease on the waiting list as cirrhosis-associated immune dysfunction contributes to immune paresis and impaired anti-microbial response [22,23]. Therefore, patients with cirrhosis are at increased risk of infections due to impaired immuni-Am J Transl Res 2024;16(4):1353-1365 nificantly in the tumor microenvironment to result in immune escape of malignant tumors [26,27].…”