Use of Transcriptional Biomarkers To Identify Liver Transplant Recipients Who Can Successfully Discontinue Immunosuppressive Therapy
Benitez, Carlos Jose Lozano, Juan Martinez-Llordella, Marc Puig-Pey, Isabel Lopez, Marta Tisone, Giuseppe Pirenne, Jacques Rimola, Antoni Sanchez-Fueyo, Alberto
Munksgaard International Publishers
American Journal of Transplantation vol:10 pages:191-192
10th American Transplant Congress location:San Diego: CA date:MAY 01-05, 2010
A fraction of liver transplant recipients are able to discontinue all immunosuppressive therapies without rejecting their grafts and are said to be operationally tolerant to the transplant. However, accurate identification of these recipients remains a challenge. To design a clinically applicable molecular test of operational tolerance in liver transplantation, we studied transcriptional patterns in the peripheral blood of 80 liver transplant recipients and 16 nontransplanted healthy individuals by employing oligonucleotide microarrays and quantitative real-time PCR. This resulted in the discovery and validation of several gene signatures comprising a modest number of genes capable of identifying tolerant and nontolerant recipients with high accuracy. Multiple peripheral blood lymphocyte subsets contributed to the tolerance-associated transcriptional patterns, although NK and γδTCR+ T cells exerted the predominant influence. These data suggest that transcriptional profiling of peripheral blood can be employed to identify liver transplant recipients who can discontinue immunosuppressive therapy and that innate immune cells are likely to play a major role in the maintenance of operational tolerance in liver transplantation.