Role of cytokine gene polymorphisms in acute rejection and renal impairment after liver transplantation

Jonsson, Julie R., Hong, Cui, Purdie, David M., Hawley, Carmel, Isbel, Nicky, Butler, Maree, Balderson, Glenda A., Clouston, Andrew D., Pandeya, Nirmala, Stuart, Katherine, Edwards-Smith, Catherine, Crawford, Darrel H., Fawcett, Jonathon and Powell, Elizabeth E. (2001) Role of cytokine gene polymorphisms in acute rejection and renal impairment after liver transplantation. Liver Transplantation, 7 3: 255-263. doi:10.1053/jlts.2001.22450

Author Jonsson, Julie R.
Hong, Cui
Purdie, David M.
Hawley, Carmel
Isbel, Nicky
Butler, Maree
Balderson, Glenda A.
Clouston, Andrew D.
Pandeya, Nirmala
Stuart, Katherine
Edwards-Smith, Catherine
Crawford, Darrel H.
Fawcett, Jonathon
Powell, Elizabeth E.
Title Role of cytokine gene polymorphisms in acute rejection and renal impairment after liver transplantation
Journal name Liver Transplantation   Check publisher's open access policy
ISSN 1527-6465
Publication date 2001
Sub-type Article (original research)
DOI 10.1053/jlts.2001.22450
Open Access Status
Volume 7
Issue 3
Start page 255
End page 263
Total pages 9
Place of publication USA
Publisher W.B. Saunders
Collection year 2001
Language eng
Subject C1
321029 Surgery
730109 Surgical methods and procedures
Abstract Although immunosuppressive regimens are effective, rejection occurs in up to 50% of patients after orthotopic liver transplantation (OLT), and there is concern about side effects from long-term therapy. Knowledge of clinical and immunogenetic variables may allow tailoring of immunosuppressive therapy to patients according to their potential risks. We studied the association between transforming growth factor-beta, interleukin-10, and tumor necrosis factor alpha (TNF-alpha) gene polymorphisms and graft rejection and renal impairment in 121 white liver transplant recipients. Clinical variables were collected retrospectively, and creatinine clearance was estimated using the formula of Cockcroft and Gault. Biallelic polymorphisms were detected using polymerase chain reaction-based methods. Thirty-seven of 121 patients (30.6%) developed at least 1 episode of rejection. Multivariate analysis showed that Child-Pugh score (P =.001), immune-mediated liver disease (P =.018), normal pre-OLT creatinine clearance (P =.037), and fewer HLA class 1 mismatches (P =.038) were independently associated with rejection, Renal impairment occurred in 80% of patients and was moderate or severe in 39%, Clinical variables independently associated with renal impairment were female sex (P =.001), pre-OLT renal dysfunction (P =.0001), and a diagnosis of viral hepatitis (P =.0008), There was a significant difference in the frequency of TNF-alpha -308 alleles among the primary liver diseases. After adjustment for potential confounders and a Bonferroni correction, the association between the TNF-alpha -308 polymorphism and graft rejection approached significance (P =.06). Recipient cytokine genotypes do not have a major independent role in graft rejection or renal impairment after OLT, Additional studies of immunogenetic factors require analysis of large numbers of patients with appropriate phenotypic information to avoid population stratification, which may lead to inappropriate conclusions.
Keyword Gastroenterology & Hepatology
Primary Biliary-cirrhosis
Chronic Hepatitis-c
Transforming Growth-factor-beta-1
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 26 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 14 Aug 2007, 16:38:35 EST