Peripheral Blood CD4+ Cell ATP Activity Measurement To Predict HCC Recurrent Post DCD Liver Transplant

Background and Aim:Hepatocellular carcinoma recurrence after orthotopic liver transplantation (OLT) still bothers transplant surgeon and physician nowadays. There are no effective methods to predict those at risk for recurrence so far although many research were looking for some meaningful biomarkers. The ImmuKnow assay is an immune cell function assay that detects cell-mediated immunity in an immunosuppressed population, which mainly measure peripheral blood CD4+ adenosine triphosphate (ATP) release. The aim of this study was to assess the relationship between cellular immune function measured by the ImmuKnow assay and HCC recurrence post OLT.Methods:From January 2008 to December 2010,76 HCC cases were done DCD liver transplant which confirmed hepatocellular carcinoma by histology post operation at the first affiliated hospital of Zhejiang University. The ImmuKnow assay was prospectively performed in them varies 6-36 months post-OLT. Every test was repeated one week later which was taken the average value for every patient. Also, every case has liver image findings at exam time approximately.Results:15 cases liver image findings showed HCC recurrence (19.7%) post OLT, the average ImmuKnow assay in these patients was 190±48 ng/mL, which were lower (P< 0.05) in comparison with patients without HCC recurrence whose average ATP level showed 313±90ng/mL. ATP levels post-OLT were found to be significantly associated with the risk of tumor recurrence. The ratio of T reg cell, the levels of TGF-P and IL-10 were higher in recurrent patients compared with recurrence-free patients.Conclusion:Greater suppression of cellular immunity, as measured by the ImmuKnow assay, is associated with progression of HCC recurrence post OLT. ImmuKnow assay is helpful in determining the risk for early recurrence of HCC post liver transplant.A pathway consist of T reg cell, TGF-P and IL-10 may was HCC recurrent predominant pathway.