Background: Accumulating evidence suggests that regulatory B cells (Bregs) play an important role in modulating inflammation and autoimmune diseases. However, whether Bregs regulate acute liver rejection in patients after transplantation still remains unclear.

Methods: 97 patients receiving liver allografts from donation after cardiac death (DCD) donors were included in this retrospective study. Perioperative proportions of circulating Bregs were calculated by flow cytometry analysis(FCM). Clinical data of the patients were also analyzed.

Results: 3 patients showed significantly increased serum ALT and AST, accompanied with gradual increase of serum bilirubin. Acute liver rejection were diagnosed by liver biopsy in these 3 cases. In contrast to the findings that the proportions of CD19⁺CD24⁺CD27⁺ Bregs were not changed significantly in patients with normal liver function without acute rejection after transplantation, significantly decreased proportions of CD19⁺CD24⁺CD27⁺ Bregs were observed at 7 or 14 days post transplantation in all 3 acute liver rejection cases. The immunosuppressant was then changed from mycophenolate mofetil to tacrolimus in on case, while the other two patients received high-dose glucocorticoid therapy. Interestingly, the proportions of Bregs markedly increased after these treatments. The liver function was also improved as evidenced by decreased serum levels of ALT, AST and bilirubin. Additionally, there are another two cases of patients also displayed increased serum levels of ALT, AST and bilirubin. However, no changes were found regarding Breg proportions. Of note, no acute liver rejection occurred but hemolytic jaundice was diagnosed in these two patients.

Conclusions: Our results suggested an important role of the frequency of circulating Bregs in predicting acute liver rejection in patients undergoing liver transplantation. However, further studies with larger numbers of patients are required to dissect the precise function of Bregs in transplant tolerance.

CITATION INFORMATION: Zhou H., Rao Z., Lu Y., Rao J., Gu J., Lu L., Xia Y. Reduction in Circulating CD19⁺CD24⁺CD27⁺ Regulatory B Cell Frequency Predicts Acute Rejection in Liver Transplant Patients Am J Transplant. 2017;17 (suppl 3).

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