Persistent Lymphopenia in Liver Transplantation and Its Molecular Insights for Hepatocellular Carcinoma

NCT06368349 | Completed

• 1 other identifier: 202101771B0
• Study Type: observational
• Target: 190
• Locations: 1 country
• Sites: 1

Brief Summary

A total of 145 Liver transplantation (LT) recipients with hepatocellular carcinoma (HCC) were retrospectively enrolled at Kaohsiung Chang Gung Memorial Hospital between 2006 and 2019. Clinical records from 7 days before LT (pre-LT) to 1 year after LT (post-LT) were analysed. In a prospective study from March 2022 to June 2023, 20 lymphopenia and 25 non-lymphopenia HCC recipients were enrolled, and a phenotypic analysis of peripheral blood lymphocytes was performed using multiparameter flow cytometry.

Conditions

Lymphopenia

Keywords

Liver transplantation; immune cell subtype; immunosuppressant

Outcome Measures

Primary Outcomes (3)

• Persistent lymphopenia predict poor overall survival

  The clinical records of 145 patients with HCC from seven days pre-LT to one-year post-LT illustrated that the longitudinal values of lymphocytes were persistently low in patients with peritransplant high neutrophil lymphocyte ratio, indicating a significant decrease in survival rate when compared to other patients.

  From 2006 to 2019

• T cell and its subtype were mainly decrease in pre-LT lymphopenia population of HCC patient

  A significant decrease in cell counts and percentage of overall T cells in the peritransplant lymphopenia group. In particular, the counts of T cell subsets, T helper cells, and cluster of differentiation 8 (CD8+) cytotoxic/activated T cells significantly decreased in the peritransplant lymphopenia group with all of their naïve, effector, and memory forms.

  From March 2022 to June 2023

• Long-term peri-LT lymphopenia HCC recipients is associated with increased sirolimus use and decreased tacrolimus use

  In the subset of 116 of 145 HCC recipients (80%) who did not experience or recover from lymphopenia, no significant associations were observed with immunosuppressant use. Surprisingly, HCC recipients with long-term peritransplant lymphopenia exhibited a significant association with increased sirolimus use (p = 0.024) and decreased tacrolimus use (p = 0.001), whereas those with post-LT lymphopenia showed no association with the use of different immunosuppressants.

  From 2006 to 2019

Eligibility Criteria

• Age: 20 Years - 80 Years
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

A total of 190 Liver transplantation (LT) recipients were enrolled including 145 cases for retrospective and 45 cases for perspective

You may qualify if:

• liver transplant patient

You may not qualify if:

• End-stage liver disease scoring system score (MELD score) \> 25
• Have received care in the intensive care unit (ICU) before transplantation
• Poor cardiovascular function.
• Patients suffering active infection.
• Other complications affecting living donor liver transplantation

Sponsors & Collaborators

• Chang Gung Memorial Hospital: lead

Study Sites (1)

Department of Surgery

Kaohsiung City, 833, Taiwan

Location

MeSH Terms

Conditions

Lymphopenia

Condition Hierarchy (Ancestors)

Leukopenia; Cytopenia; Hematologic Diseases; Hemic and Lymphatic Diseases; Leukocyte Disorders; Immunologic Deficiency Syndromes; Immune System Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: OTHER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 11, 2024
• First Posted: April 16, 2024
• Study Start: March 1, 2022
• Primary Completion: June 21, 2023
• Study Completion: June 30, 2023
• Last Updated: April 18, 2024

Record last verified: 2021-10

Locations

TW (1)