Wall Shear Stress And Intrahepatic Leukocytes Of Graft In Living Related Donor Liver Transplantation

Background/Aims: We investigated the influence of HTK solution against natural killer T cells and thymic T cells in liver graft before and after perfusion in adult living related donor liver transplantation.Methodology: Graft samples were obtained before liver resection, after perfusion, and one hour after liver transplantation. Flowcytometry analysis was conducted using several human natural killer markers; CD16, CD56, CD57, and CD161.Results: Natural killer T cells existed prominently in the liver leukocytes compared with their presence in peripheral blood lymphocytes, and the difference was significant. CD56(+)T and CD161(+)T cells, in comparison with CD16(+)T cells and CD57(+)T cells, were especially numerous in the liver. The proportion of CD56(+)T and CD161(+)T cells increased in the graft immediately after perfusion with HTK solution. However, CD16(+)T cells and CD57(+)T cells decreased in the graft immediately after perfusion and reperfusion of portal blood flow. Thymus-derived cells also decreased significantly after perfusion. The proportion of CD56(+)T cells among CD3(+) cells showed a significant increase immediately after perfusion. All types of natural killer cells in the graft immediately increased after perfusion by HTK solution and reperfusion of portal blood flow. Compared with CD57(+)NKT cells, CD56(+)NKT cells showed a significant tendency to stay in the liver graft against the perfusion. CD57(+)NKT cells tended to wash out from the liver into the systemic circulation. Moreover, thymus-derived T cells showed the strongest tendency to wash out from the liver graft.Conclusions: CD56(+)NKT cells and natural killer cells are more involved in local immunity, whereas thymus-derived cells and CD57(+)NKT cells are involved in regulation of systemic immunity. Alloimmunity between local and systemic systems may be affected by the dynamic changes in hepatic circulation associated with living related donor liver transplantation.