Correlation Between Human Leukocyte Antigen And Post-transplantation Drug-induced Liver Injury Of Han Population In Hunan Province

OBJECTIV1.To identify the susceptible genes and protective genes of PTDILI in Hunan Province,and provide guidances for clinical individualized drug administration.2.To find out if Cyclosporine A (CsA) or Tacrolimus(Tac) based immunosuppressive regimens lead to different onset risks of PTDILI under the principle of "Low dosage of Drugs and Monitored Low Concentration in Blood".3.To demonstrate the incidence of PTDILI in different age groups,and find out if old age plays a role in the pathogenesis of PTDILI.METHODSFrom 2003 to 2010,Several hundreds of patients accepted kidney transplantation in our center,their personal information, clinical examination results and HLA phenotypes were collected,all patients were followed up as possible as we could, 225 patients with complete data were enrolled in our study. Among the 225 patients,there were 52 patients in PTDILI group,173 patients in non-PTDILI group,we compared the frequency of each HLA phenotypes between the PTDILI and non-PTDILI groups with chi-square test;The 225 Patients were divided into CsA group and Tac group according to the characteristics of immunosuppressive regimen,we compared the incidence of PTDILI of the two groups with chi-square test;All the patients were then divided into elderly group (age≥40) and low-age group (age<40),the incidences of PTDILI were calculated and compared between the two groups with chi-square test.RESULTS①HLA-B51 and HLA-DR3 maybe the susceptible genes of PTDILI in Hunan Province,no protective gene was found in our study;②Low dosage of CNIs drugs were applied to prevent rejection,the drug concentration in blood was monitored routinely. In this case,there was significant difference in the incidence of PTDILI when compared between CsA and Tac groups;③The incidence of PTDILI in elderly group was significantly higher than that in low-age group.CONCLUSIONHLA-B51 and HLA-DR3 are the susceptible genes of PTDILI in Hunan Province, if we find any recipient with each one of the two genes, we should pay special attention to him(or her),routinely monitor liver function,and adjust immuno-suppressant when necessary;Compared with Tac, CsA significantly increased the incidence of PTDILI;The incidence of PTDILI in elderly group was significantly higher than that in low-age group, so it is more important for us to monitor and control posttransplantational liver function. Establishing individualized immunosuppressive regimen is also necessary.