Induction of rejection after small-for-size liver transplantation

TY - JOUR

T1 - Induction of rejection after small-for-size liver transplantation

T2 - size matters

AU - Dirsch, Olaf

AU - Li, Jun

AU - He, Qing

AU - Ji, Yuan

AU - Gu, Yan Li

AU - Dahmen, Uta

PY - 2009/1/23

Y1 - 2009/1/23

N2 - BACKGROUND: Reduced-size liver transplantation is associated with liver regeneration. This study was designed to analyze the influence of graft size on liver rejection and liver regeneration.METHODS: Reduced-size liver transplantations were performed in the rejecting ACI to Lewis and the graft acceptance BN to Lewis strain combination. The BN to Lewis control group was treated with the immunosuppressive drug FK506.RESULTS: An accelerated liver rejection in the ACI to Lewis strain combination was found in small-for-size partial liver grafts. Graft weight to recipient liver weight ratio (GW/RLW) showed a positive correlation with survival time. In the BN to Lewis strain combination, lethal rejection was seen in small-for-size partial liver grafts. A critical immunologic GW/RLW of 33% was calculated. In rats dying from lethal rejection, GW/RLW and survival time showed a positive correlation. However, GW/RLW showed a negative correlation with hepatocellular proliferation. In regenerating livers, MHC II upregulation was also observed in the control group. All control animals survived small-for-size liver transplantation.CONCLUSIONS: The relative graft size seems to be a decisive factor influencing the kinetic of liver rejection and the induction of liver rejection. Relative critical immunologic liver mass was determined to be 33%.

AB - BACKGROUND: Reduced-size liver transplantation is associated with liver regeneration. This study was designed to analyze the influence of graft size on liver rejection and liver regeneration.METHODS: Reduced-size liver transplantations were performed in the rejecting ACI to Lewis and the graft acceptance BN to Lewis strain combination. The BN to Lewis control group was treated with the immunosuppressive drug FK506.RESULTS: An accelerated liver rejection in the ACI to Lewis strain combination was found in small-for-size partial liver grafts. Graft weight to recipient liver weight ratio (GW/RLW) showed a positive correlation with survival time. In the BN to Lewis strain combination, lethal rejection was seen in small-for-size partial liver grafts. A critical immunologic GW/RLW of 33% was calculated. In rats dying from lethal rejection, GW/RLW and survival time showed a positive correlation. However, GW/RLW showed a negative correlation with hepatocellular proliferation. In regenerating livers, MHC II upregulation was also observed in the control group. All control animals survived small-for-size liver transplantation.CONCLUSIONS: The relative graft size seems to be a decisive factor influencing the kinetic of liver rejection and the induction of liver rejection. Relative critical immunologic liver mass was determined to be 33%.

KW - Animals

KW - Graft Rejection

KW - Graft Survival

KW - Histocompatibility Antigens Class II

KW - Immunosuppressive Agents

KW - Liver Regeneration

KW - Liver Transplantation

KW - Living Donors

KW - Male

KW - Models, Animal

KW - Organ Size

KW - Rats

KW - Rats, Inbred ACI

KW - Rats, Inbred BN

KW - Rats, Inbred Lew

KW - Tacrolimus

KW - Time Factors

KW - Transplantation, Homologous

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1080/08941930802216823

DO - 10.1080/08941930802216823

M3 - SCORING: Journal article

C2 - 19160137

VL - 21

SP - 288

EP - 298

JO - J INVEST SURG

JF - J INVEST SURG

SN - 0894-1939

IS - 5

ER -