The Dynamic Changes in Soluble CD30 and Regulatory T Cells Before and After Solid Organ Transplantations: A Pilot Study

Terzieva, Valentina; Mihova, Antoaneta; Altankova, Iskra; Velikova, Tsvetelina; Donchev, Deyan; Uzunova, J; Goncharov, Andrey; Jurukova, Nonka; Georgieva, Viktoriya; Yordanova, E.; Sekulovski, Metodija; Chalamanov, Ognian; Spassov, Lubomir

doi:10.1089/mab.2019.0010

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…In a small number of patients, we found a pick in the percentage of Tregs at day 7 (D7) followed by a decrease until D30 being always around and above healthy controls values independently of the diagnosis or age. The simultaneous routine measurement of liver function laboratory parameters revealed that the increase in Tregs precedes albumin synthesis restoration [122]. In another study Baumann et al evidence that the benign clinical course of subclinical rejection (SCR) compared to acute clinical rejection (ACR) is associated with intrahepatic T cell infiltration patterns showing less cytotoxic T cells and more CD4 + FOXP3+ Tregs.…”

Section: The Impact Of Regulatory T Cells On the Operational Tolerancementioning

confidence: 99%

Regulatory T Cells in the Mosaic of Liver Transplantation Tolerance

Terzieva¹,

Uzunova²,

Gornev³

et al. 2021

Organ Donation and Transplantation

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The success of transplantation depends on multiple factors, but the establishment of immune tolerant milieu is of critical importance. Hepatic environment consists of different cellular populations with prominent capacity to tolerate a huge range of antigens. Among them, regulatory T cells (Tregs) play an important role. They control the strength of immune reactions against non-self antigens and were shown to have an impact on the establishment of immune tolerance in the post-transplantation period. Furthermore, they impact a particular state after transplantation – operational tolerance. The abundant data show that Tregs might be manipulated, which suggests their further implementation as a treatment strategy. Tregs are also a very attractive target as a biomarker in the monitoring of post-transplantation period. Here, we review the particular role of Tregs among the broad spectrum of immune tolerance mechanisms of the liver in the light of the current directions of medical research.

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Section: The Impact Of Regulatory T Cells On the Operational Tolerancementioning

confidence: 99%

Regulatory T Cells in the Mosaic of Liver Transplantation Tolerance

Terzieva¹,

Uzunova²,

Gornev³

et al. 2021

Organ Donation and Transplantation

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“…At the same time, the percentage of regulatory T cells was within the reference range (4.77%, our established reference ranges of 4%-8%)[ 12 ] being less affected by the therapy. Our previous study showed that regulatory T cells have a particular dynamic during the early post-LT period[ 13 ].…”

Section: Treatmentmentioning

confidence: 99%

ABO-nonidentical liver transplantation from a deceased donor and clinical outcomes following antibody rebound: A case report

Peruhova

Georgieva

Yurukova

et al. 2020

WJT

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BACKGROUND Although ABO-nonidentical and ABO-incompatible liver transplantation (LT) are other options for end-stage liver disease treatment, the development of antibodies against blood group antigens (anti-A/B antibodies) is still a challenge in managing and follow-up of the recipients. CASE SUMMARY A 56-year-old male with end-stage liver disease with rapid deterioration and poor prognosis was considered to receive a deceased ABO-nonidentical liver graft. All required tests were performed according to our pre-LT diagnostic protocol. The orthotopic LT procedure involving O+ donor and A1B+ recipient was performed. Our treatment strategy to overcome the antibody‐mediated rejection included a systemic triple immunosuppressive regimen: methylprednisolone, mycophenolate mofetil, and tacrolimus. The immunological desensitization consisted of the chimeric anti-CD20 monoclonal antibody rituximab and intravenous immunoglobulins. The patient was also on antibiotic treatment with amoxicillin/clavulanate, cefotaxime, and metronidazole. On the 10 th postoperative day, high titers of IgG anti-A and anti-B antibodies were found in the patient’s plasma. We performed a liver biopsy, which revealed histological evidence of antibody-mediated rejection, but the rejection was excluded according to the Banff classification. The therapy was continued until the titer decreased significantly on the 18 th postoperative day. Despite the antibiotic, antifungal, and antiviral treatment, the patient deteriorated and developed septic shock with anuria and pancytopenia. The conservative treatment was unsuccessful, which lead to the patient’s fatal outcome on the 42 nd postoperative day. CONCLUSION We present a patient who underwent ABO-nonidentical LT from a deceased donor. Even though we implemented the latest technological advancements and therapeutic approaches in the management of the patient and the initial results were promising, due to severe infectious complications, the outcome was fatal.

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