Abstract
15 of 40 hepatic allograft recipients for whom immunologic data was available were 18 yrs or younger. Four of these patients have expired, none with evidence of significant graft rejection. At the time of transplantation (Tx) these patients had a significantly decreased proportion of OKT3+ cells compared to normal subjects (p<0.01). There was no significant difference in lymphocyte subset proportions between patients with primary biliary atresia (6 pts) and those with non A non B hepatitis (6 pts). Four weeks post Tx (pTx), when most patients were receiving relatively low doses of glucocorticoid (≤0.5 mg/kg/d) and oral cyclosporine (Cyc) (15 mg/kg/d), the proportion of OKT4+ cells had declined from 37.5 ± 10.3% to 30.4 ± 10.2%. By 52 weeks it had risen to 35.5±13.4%. By contrast adult T4+ cells dropped from 37.9% pre Tx to 29.1% at 4 wks and 26.4% at 52 weeks pTx. In vitro studies demonstrated a nadir in IgM and IgG synthesis at 4 weeks pTx (pre: IgM 409±273 ng/ml; IgG 361±653 ng/ml vs 4 wk: IgM 0±0 ng/ml p <0.01; IgG 48±95 ng/ml p <0.01). Three patients followed serially for 52 weeks had a return of Ig synthesis (pre: IgM 265±264 ng/ml; IgG 485±742 vs 1 yr pTx: IgM 273±55 ng/ml; IgG 1227±1787). These studies indicate that children who receive hepatic allografts and who are maintained primarily on Cyc immunosuppression appear to be less likely to have a prolonged depression of T4+ cells than adults. Furthermore, children demonstrate improved immune function by 12 mos post transplant.
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Herrod, H., Williams, J. 983 IMMUNOLOGIC STUDIES IN PEDIATRIC RECIPIENTS OF HEPATIC ALLOGRAFTS. Pediatr Res 19, 274 (1985). https://doi.org/10.1203/00006450-198504000-01013
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DOI: https://doi.org/10.1203/00006450-198504000-01013