Changes of T lymphocyte subset and its function in patients with chronic severe hepatitis or hepatocellular carcinoma during the perioperation of liver transplantation

Abstract

Objective To investigate the changes of T lymphocyte subset and its function in patients with chronic severe hepatitis or hepatocellular carcinoma(HCC) during the perioperation of liver transplantation. Methods Twenty patients who underwent orthotopic liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from September 2008 to July 2009 were enrolled in this prospective study. According to their primary disease, the patients were divided into 2 groups: SH group [patients with chronic severe hepatitis, n=10; 8 males and 2 females, mean age of (42±7) years old] and HCC group [patients with HCC, n=10; 9 males and 1 female, mean age of (47±7) years old]. Ten healthy volunteers received physical examination at the same period in the hospital were selected as the control group. The informed consents of all patients were obtained and the ethical committee approval was received. Patients in the SH group and HCC group were drawn blood sample at the time points of 30 min pre-transplantation, and 1, 3, 7, 14 d post-transplantation, while patients in the control group were taken blood sample when enrolled in the study. Parameters including percentage of T lymphocyte (T cell percentage), CD4+ CD25+ Foxp3+ regulatory T cell vs CD4+ lymphocyte (Treg percentage), Foxp3 mRNA level, IFN-γ and IL-4 level in peripheral blood were detected. The immunological detection indexes between two groups were compared using ANOVA analysis or t test. Results Before the transplantation, T cell percentage and IFN-γ/IL-4 ratio in SH group were significantly lower, compared with that in the control group (LSD-t=4.431, 3.045; P 0.05). Treg percentage and Foxp3 mRNA level in SH group were both significantly higher than that in the HCC group(LSD-t=4.253, 3.117; P 0.05). Conclusions The immune status between patients with severe hepatitis and patients with hepatocelluar carcinoma are obviously different. Detecting the change of T lymphocyte subgroup and its function is helpful to determine the immune status of patients and to make individual immunosuppressant protocol. Key words: Liver transplantation; T-lymphocytes; Hepatitis, chronic; Carcinoma, hepatocellular; T-cell antigen receptor specificity