Indian Transplant Newsletter Vol. IV Issue NO.13. Oct 2002 - Feb 2003
Print ISSN 0972 - 1568

liver Transplantation

Indian Transplant Newsletter.
Vol. IV Issue NO.13. Oct 2002 - Feb 2003
Print ISSN 0972 - 1568
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Tuberculosis after liver transplantation

Tuberculosis (TB) has recently been found to cause serve infection in patients post transplantation and therefore patient care after liver transplantation should also focus on the possibility of TB developing post liver transplantation one such case study was a 31 – year –old female who underwent liver transplantation for decompensate Wilson an cirrhosis Aug 3, 1999. The post transplantation course was smooth. The immunosuppressant regimen consisted of neural and steroid –resistant rejection developed on- Aug.28 .the neural was switched to tacrolimus following which she had good liver function. Three weeks later, on Nov 18, persistent spiking fever was noted. The chest showed infiltrative lesions in the left lung. The CMV titer was increased. Bronchoscopy was performed. No virus infection was identified. The patient was treated as CMV pneumonias and the immunosuppressive agents were discontinued. However, steroid-resistant rejection developed on Aug.28. The neural was switched to tacrolimus following which she has good function. Three week later. On Nov 18, persistent spiking fever was noted. The chest showed infiltrative lesions in the left lung. The CMV titer was increased. Bronchoscopy was performed. No virus infection was identified. The patient was treated as CMV pneumonitis and the immunosuppressive agents were disconnected. However no improvement noted. Therefore, open lung biopsy was done on Dec 29 and tuberculosis was confirmed. The patient was then treated with anti-TB therapy with which the chest lesions gradually improved.

UW solution holds promise for cryopreservation of primary isolated hepatocytes

Researchers at the Second Department of Surgery, Asahikawa Medical College and the Department of Surgery, Okayama University Graduate School of Medicine and Dentistry in Japan carried out a study to evaluate the cytoprotective effect of University of Wisconsin (UW) solution during cryopreservation of rat hepatocytes. Crytopreserved hepatocytes are a ready source of metabolic and synthetic functions for hepatocyte-based biological therapies, such as hepatocyte transplantation and a bioartificial liver. These therapies are promising for the treatment of patients with liver failure and for starters, the study did demonstrate that modifications in UW-solution based cryopreservation  could be a step in the right direction.

In the study, primary rat hepatocytes were isolated by two step collagenase perfusion technique and resulting hepatocytes of >85% viability assesses. These hepatocytes were cryopreservation in UW solution with 12% DMSO (Group 1), cellbanker II solution (GROUP 2), and regular DMEN medium supplemented 10% fetal bovine serum and 12% DESO (Group 3), for 24 to144 hours. After thawing the cryopreservation hepatocytes, cell viability, cell culture, ammonia clearance activity, and efficacy of adenovirus (AdLacZ) – and lentivirus (LtLacZ) - mediated E. coli LacZ gene transfer were compared among the groups. Hepatocyte viability immediately after thawing was 60% for G1, 54%, G2 and 42% for G3, respectively, compensated by the initial cell viability. Plating and ammonia clearance of hepatocytes were significantly improved in G1 hepatocytes. Efficient transduction using AdLacZ and LtLacZ was achieved in the cryopreservation hepatocytes with UW solution.

Moving toward developing a Bioartificial Hepatic Organ

A step in the right direction in constructing a bioartificial hepatic organ was taken by researchers at the Department of Surgery, Okayama University Graduate School of Medicine And Dentisity, Japan and Harvard-massachusetts Institute of Technology when they managed to establish a human cholangiocytic cell line. The cells would be useful I providing a bile drainage system in the bioartificial hepatic organ in conjunction with hepatocytes.

The researchers had previously established human liver cell lines using simian virus 40 large T antigen (SV40T) gene. The catalytic subunit of human telomerase reverse transcriptase (hTERT) that elongates the length of telomere has been implicated as a crucial participant in the cellular immortalization process. In liver-targeted cell therapies such as a bioartificial liver, the presence of the bile drainage system is of extreme importance. The establishment of human cholangiocytes cell line would allow the provision of a structure for bile excretion and therefore the engineering of a cholangiocytes line using a retroviral vector encoding the genes of hTERT and green fluorescence protein (GFP) as a positive selectable marker was embarked upon.

One of the human liver OUMS-21 cells were retrovirally transuded with the genes of hTERT and GFP. Following retroviral transduction, cells were trypsinized, dissociated into a single-cell were suspension, and subjected to FACS for GFP. Eventually, a single cell clone was obtained by a limiting dilution method. One of resulting clones, OUMS-21/hTERT , was established and used in the present study. Telomerase activity and gene expression of liver marker were also examined. It was found that the OUMS-21hTERT cells showed telomerase activity, whereas parental cell had activity. This data was consistent with the unlimited proliferative property of OUMS-21/hTERT   cells. The cells showed the expression of cytokeratin 7 and 19 as a marker of cholangiocytes by RT-PCR and Western blotting analysis. In contrast, the cells were negative for hepatocytes-specific marker such as albumin, or bilirubin UGT. OUMS-21/ hTERT cells demonstrated well-organized web formation in a Matrigel assay, which suggests cholangiogenetic potential of the cells.


To cite : Shroff S, Navin S. liver Transplantation. Indian Transplant Newsletter Vol. IV Issue NO.13. Oct 2002 - Feb 2003.
Available at:
https://www.itnnews.co.in/indian-transplant-newsletter/issue13/Hepatitis-B-C-Virus-infection-in-renal-transplant-recipients-762.htm

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