Peripheral Th17 cell frequencies predict postoperative complications in patients with hepatitis B virus-related liver cirrhosis following liver transplantation

Abstract

To investigate the relationship between level of Th17/CD4+T cell ratio in peripheral blood and postoperative complications in patients with hepatitis B virus (HBV)-related cirrhosis after orthotopic liver transplantation (OLT). Fifty-one patients with HBV-related cirrhosis who received OLT were enrolled in this study. Flow cytometry analysis was performed to measure the proportion of Th17 cells to CD4+T cells at the following time points:pre-OLT, and post-OLT days 7, 14 and 21. The relevant hepatic biochemistry indexes, serum concentration of FK506 and level of procalcitonin (PCT) were detected for all patients after OLT. The transplant recipients were divided into four groups according to the postoperative complication, which included acute rejection (AR, n=12), postoperative infection (POI, n=10), transient intrahepatic cholestasis (TIHC, n=12) and no complications (n=17). The Th17/CD4+T cell frequencies were notably higher in the AR patients after OLT (vs. before OLT, P less than 0.01) and this increase was positively correlated with rejection activity index (RAI; r=0.759, P=0.004). Up to post-OLT day 14, the frequencies of Th1 7/CD4+T cells in the POI group were similar to those of the AR group but they decreased to near-baseline level at post-OLT day 21.Furthermore, the percentage of Th17/CD4+T cells in the POI group was positively correlated with PCT (r=0.768, P=0.010). The frequencies of Th17/CD4+T cells in the TIHC and no complications groups showed a slowly decreasing trend after OLT and became markedly lower than the before OLT levels (P<0.01). The concentration of FK506 in the AR group was significantly lower than that in the other groups at post-OLT day 14 (P=0.000). Th17/CD4+T cell level in peripheral blood might be a useful marker for risk assessment and monitoring of OLT postoperative complications, such as acute rejection and postoperative infection, in the early stage, and might help to improve patient prognosis by allowing for timely application of anti-rejection and antibacterial agents.