Humoral immune system improves after liver transplantation

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Background: Cirrhosis has been associated with a severe immune deficiency that affect all immune cell types and the humoral immune system, resulting in a high infection and infection-related mortality rate. After liver transplantation (LTX), pharmacological immunosuppression supersedes the underlying immune dysfunction, and infections remain a frequent type of complication. We recently designed a functional biomarker (acellular growth retardation assay – AGRA) that determines the humoral immune state in patients with chronic liver disease and predicts the occurrence of severe infections in this patient group. Here we use this biomarker to monitor the development of the humoral immune system after liver transplantation and test whether AGRA can predict severe infections post LTX. Materials and methods: Therefore, a clinical study was conducted in which 55 patients undergoing liver transplantation were included. Shortly before transplantation, one day, one week, and three months after the prophylactic antibiotic regime ended, serum samples were collected, and AGRA was assessed. Time to infections, complications, or death were recorded one year after liver transplantation. Infections were retrospectively recorded in the year before liver transplantation for comparison. Results: Patients included in the study were on average 59.7 (±9.6) years old, 31% of them were female. During the first year after transplantation, 60 clinically relevant infections (i.e. hospitalization and medication) were recorded in a total of 28 individual patients. In comparison, 26 pre-transplant infections were recorded in 21 individual patients. AGRA as a biomarker for the state of the humoral immune system gradually improved after liver transplantation and became significantly lower compared to pre-transplant measurements one week and three months after transplantation. AGRA measurements pre-transplant were not able to predict the occurrence of clinically relevant infection after LTX. Conclusions: The state of the humoral immune system as assessed by the novel biomarker AGRA improves gradually over the first three months after LTX. The state of the humoral immune system, however, was not a determining factor for the development of infections post LTX. Publication History Article published online: 05 June 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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