Background: Bacteremia is one of the leading causes of mortality in living-donor liver transplant (LDLT) recipients. Lymphocytes, including natural killer cells, are believed to play a role in the first line of defense against invading infectious microbes.
Methods: From January 2004 to December 2009, 114 consecutive LDLT recipients were studied for postoperative bacteremia. The impact of adjuvant immunotherapy using activated liver allograft-derived lymphocytes on bacteremia was retrospectively evaluated by a one-to-one match using propensity score to overcome bias due to the different distribution of covariates for the two groups.
Results: After one-to-one matching, 21 patients who did not receive adjuvant immunotherapy and 21 who did not receive adjuvant immunotherapy had the same preoperative and operative characteristics. Six (28.6%) of the 21 patients who did not receive adjuvant immunotherapy had bacteremia, whereas only one (4.8%) of the 21 patients who received adjuvant immunotherapy had bacteremia; thus, the incidence of bacteremia in patients who had received adjuvant immunotherapy was significantly lower than that in patients who had not received adjuvant immunotherapy (P=0.038).
Conclusions: Adjuvant immunotherapy using liver allograft-derived lymphocytes may be a promising modality for reducing the postoperative bacteremia after LDLT.