[Immunologic surveillance of liver transplant patients using monoclonal antibodies against lymphocyte subpopulations]

A precise immunological surveillance of liver graft recipients can allow the adaptation to each patient of an adequate immuno-suppressive treatment. In 11 liver-transplanted patients (7 primitive biliary cirrhoses, 2 post-hepatic cirrhoses, one bile duct atresia with one antitrypsin deficit) different lymphocyte subpopulations were tested before transplantation and at days 3, 5, 7, 15, 30, 60 and 120 after grafting using OKT3, OKT4, OKT8 (Orthoclone, France). In 6 patients presenting one or more rejections, the (T4+):(T8+) lymphocyte ratio was significantly increased during the days preceding rejection. In all cases, the (T4+):(T8+) ratio increase was linked to a (T4+) helper lymphocyte augmentation. In the 6 patients who did not present any rejection, the (T4+):(T8+) ratio did not increase at long term. A decrease of the (T4+):(T8+) ratio, along with an augmentation of (T8+) lymphocytes, was noticed at long term in patients free of chronic rejection. The evolution of T lymphocyte populations, followed using monoclonal antibodies and mainly the (T4+):(T8+) ratio, can provide a test for rejection predictability of for the prognosis of tolerance to liver allografts.