BACKGROUND:Human CD8 + CD28 - T-suppressor(Ts) cells have been considered to indicate a reduced need for immunosuppression in pediatric liver-intestine transplant recipients and recipients of deceased heart-kidney transplants.However,in adult-to-adult living donor liver transplantation(A-A LDLT)little information is available and the clinical significance is still unknown. METHODS:Flow cytometry was used to detect the population of CD8+CD28 -Ts cells present in peripheral blood in A-A LDLT recipients(n=31),patients with end- stage liver disease(n=24)and healthy controls(n=19). Meanwhile,we tested the graft function and trough levels of immunosuppression in recipients.The clinical and follow- up data of 31 transplant recipients were analyzed. RESULTS:Compared with diseased controls(P=0.007) and healthy individuals(P=0.000),a notable expansion of CD8 + CD28 - Ts cells was found in recipients of A-A LDLT.This was associated with graft function,levels of immunosuppression and rejection episodes. CONCLUSIONS:To monitor the CD8 + CD28 - Ts cells levels is important to evaluate the immune state of recipients. Meanwhile,it is also important to promote expansion of CD8+CD28 -Ts cells in recipients of A-A LDLT,not only to sustain good graft function and decrease the dosage of immunosuppressants,but also to reduce the occurrence of rejection.
Yi-Xin Lin,Lan-Lan Wang,Lu-Nan Yan,Pei Cai,Bo Li,Tian-Fu Wen and Yong Zeng Center of Liver Transplantation and Department of Surgery,Division of Clinical Immunology and Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu610041,China
Background:In paragonimiasis,the lungs and pleural cavity are the major target organs,and the central nervous system can also be affected.The liver is an organ in which ectopic paragonimiasis rarely occurs.Because the symptoms and examinations in hepatic paragonimiasis(HP)are not typical,the disease is often misdiagnosed in the clinic.Methods:From February 2008 to March 2015,our department accepted 32 patients who presented with a liver mass upon ultrasound and computed tomography imaging and in whom the source of the mass could not be identified upon numerous further diagnostic tests.We ultimately obtained surgical biopsies of their lesions for pathological examination.We analysed the clinical data of these cases,along with their disease characteristics,the diagnostic strategies employed and their treatment experiences.Additionally,we performed patient follow-up for a period of 6–12 months.Results:All patients underwent half/partial hepatectomy and were diagnosed with HP upon pathological examination.They recovered well after surgery and their original symptoms were markedly improved without recurrence.The liver functions of the patients reached normal levels before discharge and no additional liver lesions were found upon diagnostic imaging.Conclusion:The diagnosis of HP based on clinical manifestations,laboratory tests or image examination is difficult and only pathologic analysis of biopsies could confirm HP.Surgical treatment not only removes lesions,but also allows for pathologic biopsy.This study encompasses the largest number of HP patients to date,but the surgical outcomes require further research and long-term follow-up.
Xiwen YeXianze XiongNansheng ChengJiong LuYixin Lin
