Significance of Gene Polymorphism on Infectious Complications and Rejection After Liver Transplantation

H. Egawa¹, T. Kato¹, Y. Kotera¹, Y. Hirata¹, S. Yamashita¹, S. Ariizumi¹, T. Ishizuka¹, Y. Tanaka², H. Ohdan³

¹Tokyo Women's Medical University, Tokyo, Japan, ²Surgery, Hiroshima University, Hiroshima, Japan, ³Hiroshima University, Hiroshima, Japan

Meeting: 2022 American Transplant Congress

Abstract number: 1542

Keywords: Gene polymorphism, Infection, Liver transplantation, Rejection

Topic: Basic Science » Basic Clinical Science » 17 - Biomarkers: Clinical Outcomes

Session Information

Session Name: Biomarkers: Clinical Outcomes

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Clinical application of gene polymorphism is a key of precision medicine in the field of organ transplantation. Hiroshima group reported significance of Fc-gamma receptor (FcrR) polymorphism in infectious complications and FOXP3 gene polymorphism in steroid resisted acute rejection (ACR) after liver transplantation (Am J Transplant. 2016;16:625, Hepatology Communication 2017;1:406). We investigated impacts of gene polymorphism of FcrR2A (131H/R) and FcrR3A (158 F/V), and FOXP3 (rs3761548) in our liver transplant cohort in which surgical factors and immunosuppression regimens were varied from the original institution.

*Methods: One hundred and one patients underwent liver transplantation (LT) consisting of 16 deceased donor LT and 85 living donor LT from 2011 to 2020 were enrolled. Background data, operative data, and postoperative data including treated ACR, steroid resistant ACR (SRACR), de novo DSA, positive CMV antigenemia, CMV diseases requiring treatment, blood stream infection (BSI) of any kind of bacteria, gram positive coccus BSI, BSI accompanied with bacteria other than streptococcus epidermidis, and survival were collected. The relationship between the 3 polymorphism and these factors were analyzed with JMP pro15.

*Results: Variation of genotypes were HH/RH/RR: 62/37/2 in FcrR2A, FF/VF/VV: 64/30/7 in FcrR3A, and AA/AC/CC: 13/6/82 in FOXP3, respectively. Genotypes of FcrR2A were significantly associated with incidence of positive CMV antigenemia (HH/RH/RR: 68%/41%/100%, p=0.01), CMV diseases (65%/35%/100%, p=0.01), but not with BSI. FcrR3A or FOXP3 had no significant association. In 23 patients who were treated with rituximab for preformed donor specific antibody (DSA), genotypes of FCrR2a were significantly associated with the incidence of treated ACR and SRACR (HH/RH/RR:14%/75%/0%, p=0.01 and 0%/38%/0%, p=0.03, respectively) and those of FOXP3 were associated with SRACR (CC/nonCC: 6%/40%, p=0.04).

*Conclusions: Although this is a preliminary study with small cohort, genotypes of FcrR2A were significantly associated with CMV infection in our whole cohort and FcrR2A and FOXP3 were with SRACR in rituximab-treated patients. Gene polymorphism could have a potential to contribute to organ transplantation as precision medicine. A large scale multicenter study is running currently under a fund of Japan Agency for Medical Research and Development.

To cite this abstract in AMA style:

Egawa H, Kato T, Kotera Y, Hirata Y, Yamashita S, Ariizumi S, Ishizuka T, Tanaka Y, Ohdan H. Significance of Gene Polymorphism on Infectious Complications and Rejection After Liver Transplantation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/significance-of-gene-polymorphism-on-infectious-complications-and-rejection-after-liver-transplantation-2/. Accessed May 6, 2025.

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