Elevation Of Adenosine Triphosphate In CD4+T Lymphocytes With Early Immune State After Liver Transplantation

Objective There has been increasing interest in correlations between CD4+ T lymphocytes and acute rejection, infection after liver transplantation(1 months after operation). This study was attempted to explore the role of CD4+ T lymphocytes after liver transplantation.Methods 85 patients who received liver transplantation were chosen and observed, while 60 healthy people being the control group. Collecting the peripheral blood samples, blood specimen was collected preoperatively,1,2 and 4 week postoperatively, on the day when AR occurred and one week after initiation of steroid impulse therapy and the day of INF and 3 days after normal temperature of INF. ImmuKnowTM test kits for Immune cells function were used to assay the ATP value.Results ATP levels in CD4+ T lymphocytes were significantly elevated in both AR and NAR groups after transplantation, as compared with their preoperative levels, and reached the peak one week after transplantation in AR group, which was significantly higher than that of NAR group during the same period (P<0.05). ROC curve analysis showed that significant elevation of the ATP value one week after transplantation indicated a good sensitivity (85.7%) and specificity (80.9%) for diagnosis of AR when the cutoff value was 407μg/L. The ATP value collected on the day of AR occurrence had a significant positive correlation with the rejection acting index(RAI)(P<0.01). AR was reserved one week after steroid impulsive treatment, when the ATP value declined significantly compared with that of the control group and that on the day of AR occurrence (P<0.01).ATP values of INF group is low at preoperatively, it reaches the lowlands level at 1st week and was apparently lower than those of the contemporary NINF group (p<0.01). By ROC curve analysis, the obvious drop of the ATP value 1st week postoperatively has better sensitivity and specificity in diagnosing the INF. The ATP sensitivity rate for early AR was 85% and specificity rate 91%. The ATP value at the day of INF has positive relationship with the infection. After the antibiotics treatment, the ATP value at 3 days after normal temperature elevated significantly compared with the day when INF occurred(P<0.01).Conclusion The ATP values within CD4+T lymphocyte has the preferable relevance in acute rejection,infection after liver transplantation. During the postoperative period of liver transplantation, detected the indexes above, were practical utility for assessing their status of immunization and planning individual therapy.