Pediatric patients receiving ABO-incompatible living related liver transplantation exhibit higher serum transforming growth factor-b1, interferon-c and interleukin-2 levels

Background ABO-incompatible liver transplantation (LTx) is becoming more common in response to the paucity of liver allografts. Several studies have expressed concern about the effect of ABO compatibility on graft survival. Purpose To evaluate the differences in serum cytokine levels between ABO-incompatible (ABO-i) and ABO-compatible (ABO-c; includes ABO-compatible and identical) pediatric LTx recipients during regular outpatient follow-up. Note that, in the field of organ transplantation, transplants are categorized as incompatible, compatible or identical; accordingly, these are the terms we use in the paper. Materials and methods A clinical outpatient study measuring serumtransforming growth factor (TGF)-b1, interferon (IFN)-c, interleukin (IL)-2 and IL-10 in 43 living related liver transplantation (LRLT) recipients, of whom 36 received ABO-c LRLT (34 were ABO-identical and 2 were nonidentical) and 7 ABO-i LRLT. Serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, gammaglutamyl transpeptidase, alkaline phosphatase, lactate dehydrogenase and bilirubin weremeasured as part of the patients’ regular follow-up visits. Results There were no differences between the ABO-c and ABO-i groups in terms of recipient’s age [mean 12.6 vs. 11.1 years (y)], post-LTx duration (mean 7.3 vs. 7.3 y), donor’s age (mean 35.5 vs. 34.6 y), body weight (28.9 ± 2.9 vs. 27.9 ± 6.9 kg), or gender (19 female and 17 male vs. 4 female and 3 male). Serum TGF-b1, IFN-c and IL-2 were significantly higher in the ABO-i group than in the ABO-c group. IL-10, however, did not differ between the two groups. There was a tendency toward higher cGTP levels in the ABO-i group, but this difference did not reach significance. Conclusion ABO-incompatible LRLTx patients have higher serum TGF-b1, IFN-c and IL-2 levels as measured at regular outpatient visits. As a result, they face a higher risk of T-helper 1 cell polarization, which could make graft rejection more likely.