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Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 982163, 8 pages
http://dx.doi.org/10.1155/2013/982163
Clinical Study

Immunological Aspects in Late Phase of Living Donor Liver Transplant Patients: Usefulness of Monitoring Peripheral Blood CD4+ Adenosine Triphosphate Activity

1Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan
2Department of Pharmacy, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan
3Department of Molecular and Laboratory Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan
4Department of Gastroenterology and Hepatology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan
5Translational Medical Science, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0001, Japan

Received 21 February 2013; Revised 22 July 2013; Accepted 23 July 2013

Academic Editor: Qiquan Sun

Copyright © 2013 Shugo Mizuno et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To evaluate whether the combination of the peripheral blood CD4+ adenosine triphosphate activity (ATP) assay (ImmuKnow assay: IMK assay) and cytochrome P450 3A5 (CYP3A5) genotype assay is useful for monitoring of immunological aspects in the patient followup of more than one year after living donor liver transplantation (LDLT). Methods. Forty-nine patients, who underwent LDLT more than one year ago, were randomly screened by using IMK assay from January 2010 to December 2011, and the complete medical records of each patient were obtained. The CYP3A5 genotypes were examined in thirty-nine patients of them. Results. The mean ATP level of the IMK assay was significantly lower in the patients with infection including recurrence of hepatitis C (HCV) ( ) than in those without infection ( ): 185 versus 350 ng/mL ( ), while it was significantly higher in the patients with rejection ( ) than in those without rejection ( ): 663 versus 306 ng/mL ( ). The IMK assay showed favorable sensitivity/specificity for infection (0.909/0.842) as well as acute rejection (1.0/0.911). CYP3A5 genotypes in both recipient and donor did not affect incidence of infectious complications. Conclusions. In the late phase of LDLT patients, the IMK assay is very useful for monitoring immunological aspects including bacterial infection, recurrence of HCV, and rejection.