Korean J Transplant.  2022 Nov;36(Supple 1):S273. 10.4285/ATW2022.F-4125.

The long-term perioperative lymphopenia associates with low absolute counts of T lymphocytes in liver transplantation recipients with hepatocellular carcinoma

• Hou TY
• Lin CC
• Chen DW
• Lin YH
• Yong CC
• Chen CL

• KMID: 2535500
• DOI: http://doi.org/10.4285/ATW2022.F-4125

Abstract

Background
Liver transplantation (LT) is the best treatment option for patients with hepatocellular carcinoma (HCC), however it still has unmet needs in cause of mortality after LT. Although several studies have revealed that higher absolute lymphocyte counts (ALC) leads to better outcome in HCC recipients after LT, the impact of ALC on survival at 1 year post-LT for HCC patients and the alterations of lymphocyte subsets in those lymphopenia patients are not illustrated.
Methods
A total of 145 LT recipients with HCC were retrospectively enrolled at Kaohsiung Chang Gung Memorial Hospital be-tween 2005 and 2014. Clinical records from 7 days before LT (pre-LT) to 1 year after LT (post-LT). In prospective study, 20 lymph-openia and 25 nonlymphopenia HCC recipients were enrolled, and a phenotypic analysis of peripheral blood lymphocytes was performed using multiparameter flow cytometry.
Results
The higher ALC at pre-LT, post-LT 1 year can indeed predict the better overall survival. Clinical records of 145 patients with HCC from seven days pre-LT to 1 year post-LT illustrated that the longitudinal values of lymphocytes, red blood cell, and hemoglobin were persistently low in patients with peritransplant high neutrophil lymphocyte ratio, which represented a significantly worse survival rate in association with increased red blood cell distribution width and pancytopenia when compared to other patients. We further found that only a significantly decreased in cell counts and percentage of overall T cells in peritransplant lymphopenia group. In detail, the T cell subsets T helper cells, CD8+ cytotoxic/activated T cells were significantly decreased in peritransplant lymphopenia group with all of their nave, effector and memory forms.
Conclusions
Our results demonstrated the association between hematopoietic deficiencies and with decreased overall T cells but not other immune cells of peritransplant lymphopenia in LDLT recipients with HCC might imply immune checkpoint deficiencies in association with those patients.