Effects of early developed sepsis on postoperative immune status in patients undergoing liver transplantation / 中华普通外科杂志

ABSTRACT

Objective To investigate immune status changes in liver transplant patients suffering from early developed sepsis.Methods In this study 19 patients undergoing liver transplantation for severe hepatitis from Oct 2008 to Jul 2009 were enrolled.Immune status was compared between patients of severe hepatitis and 20 healthy volunteers.According to whether early sepsis developed or not,patients were divided into sepsis group (HSS) and non-sepsis group (HSNS).T lymphocyte subgroups of the peripheral blood were compared between post-transplant and pre-transplant in these two groups on different stages.Results Comparing to volunteers,T％ and IFN-γ/IL-4 of severe hepatitis patients significantly decreased,CD4 + CD25 + Foxp3 + Treg( ％ ),Foxp3 mRNA and IL-10 significantly increased.Early sepsis developed in 9 patients.Compared with pre-transplant levels,T％ in both groups significantly decreased on the first day post transplant.T％ in HSNS group increased to the level of pretransplant while T％ of HSS group remained at the low level.Treg％ ( t =3.265,P =0.004 ) and Foxp3 mRNA ( t =2.750,P =0.013 ) of HSNS group on day 14 decreased significantly lower than that before transplantation.Those two parameters of HSS group even increased slightly.IFN-γ/IL-4 in HSNS group increased significantly on day 3 (t =2.261,P =0.036),while there was no change in HSS group.The concentration of IL-10 in both groups significantly decreased,and the level in HSNS group remained at a low level,while that in HSS group increased on day 14.Conclusions Patients with severe hepatitis have weakened immune status.The imbalance of immune status recovers gradually since 7-14 days after transplantation in patients uncomplicated with sepsis.However,the immune status of receipients complicated with sepsis fails to improve.