Background
Passenger leukocytes of donor origin are transferred to the patient resulting in circulatory
microchimerism after lung transplantation (LTx). This chimeric state has been shown
to occur in the total leukocyte fraction as well as unseparated peripheral blood mononuclear
cells (PBMCs). In this study we determined the microchimerism levels of B cells, monocytes,
natural killer (NK) and T cells and dendritic cell (DC) subsets (mDC1, mDC2 and pDC)
during the first year after lung transplantation.
Methods
To identify circulating donor cells, 11 donor–patient combinations were selected,
which were mismatched for HLA-B8. Analysis consisted of flow cytometry on a minimum
of 1 million PBMCs taken monthly up to 1 year after LTx.
Results
Levels of microchimerism were found to be stable after LTx for all cell types investigated,
although for NK+T cells an above-baseline chimerism of donor cells from the donor
lung was observed in the first month after transplantation. Circulating PBMCs consisted
of, on average, 0.002%, 1.7%, 0.03% and 0.001% of B cells, monocytes, NK+T cells and
DCs, respectively, indicating that overall levels of microchimerism differed between
the cell types investigated. In 2 patients no B-cell chimerism and in 1 patient no
DC chimerism could be detected. Cell types and DC subsets of recipient origin were
normally distributed. Conversely, monocytes, B cells and DCs of donor origin were
increased and donor NK+T cells were decreased in number, compared with the recipient
ratios. Analysis of circulating recipient DCs showed a normal distribution of mDC1s
(70%), mDC2s (5%) and pDCs (25%). However, circulating donor DCs consisted of 80%,
20% and <1% of DC subsets mDC1, MDC2 and pDC, indicating that donor plasmacytoid dendritic
cells were not detectable in the circulation.
Conclusions
In the first year after lung transplantation a stable microchimerism was detected
for all cell types investigated. However, donor pDCs were consistently absent in all
samples investigated, which may be linked with graft rejection often observed after
LTx.
Keywords
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Article info
Publication history
Published online: March 10, 2011
Identification
Copyright
© 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.