Immune Function Following Liver Transplantation

Study Overview
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Brief Summary
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Post-operative care following liver transplantation is characterized by a high incidence of infective and immunological complications. Restauration of liver function following liver transplantation is progressive and characterize a period of immuno-infective vulnerability. The purpose of this study is to characterize the early post-operative immune function in children after liver transplantation.

Detailed Description
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Within a few decades, liver transplantation has become an effective treatment of end-stage liver diseases associated with high spontaneous mortality. However, the consequences of immediate transplants are frequently complicated by infective (nosocomial infection) and immunological complications (acute graft rejection) in up to 40 to 60% of liver transplanted patients. In order to ensure graft immunotolerance, immunosuppressive therapy based mainly on calcineurin inhibitors, is initiated soon after liver transplantation. Immunosuppressive therapy is intended to reduce the response of cytotoxic lymphocytes and NK cells. As a result, an important component of the immune response is blocked. In addition, function of the transplanted liver, which is a key organ for both immuno-inflammatory signalling and host defense against pathogens, is progressively restored post-operatively. Thus in this post-transplant period, there is a critical period where liver function is severly impaired and progressively get restaured. The aim of this study is to characterize the restauration of immune function in the early post-operative period and evaluate its correlation with occurence of infective or immunological complications.

Official Title
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Immune Functional Profile as Predictor of Infective Complications Following Pediatric Liver Transplantation

Conditions
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Liver Transplant; Complications

Intervention / Treatment
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* Genetic: Biological testing on sequential blood sample


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child under 18 admitted for liver transplantation Signature of consent by the two holders of parental authority. Informing children as far as their age and condition allow. Affiliation to a social protection Exclusion Criteria: Children under 6 kg Children transplanted for primary graft dysfunction Children scheduled for liver-kidney transplants

Ages Eligible for Study
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Minimum Age: 1 Day
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Genetic: Biological testing on sequential blood sample|Biological characterization of various immune function and blood circulating leukocytes phenotyping before liver transplantation and therafter at day-3, -7, -14 postoperatively and if septic complication occurs.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Immune functionnal profile | quantitative monocytes mHLA-DR measurment | pre-operatively |