Soltys and Fox et al transplanted human hepatocytes in two patients with urea cycle defects. Retrospective immune monitoring was performed to assess the adequacy of immunosuppression. Early graft loss in both cases was accompanied by an increase in rejection-risk measured with donor-specific CD154+T-cytotoxic memory cells. Lymphocyte depleting induction immunosuppression was used in the next patient who received hepatocyte transplantation for phenylketonuria. Biochemical improvement of disease markers was confirmed in supervised follow-up for several months. In serial monitoring, rejection-risk measured with donor-reactive T-cells increased as follow-up became inconsistent and the graft was lost. The authors concluded that serial monitoring of rejection-risk could facilitate the management of immunosuppression in this type of cell transplant.

Reference: Soltys KA, Setoyama K, Tafaleng EN, Soto Gutiérrez A, Fong J, Fukumitsu K, Nishikawa T, Nagaya M, Sada R, Haberman K, Gramignoli R, Dorko K, Tahan V, Dreyzin A, Baskin K, Crowley JJ, Quader MA, Deutsch M, Ashokkumar C, Shneider BL, Squires RH, Ranganathan S, Reyes-Mugica M, Dobrowolski SF, Mazariegos G, Elango R, Stolz DB, Strom SC, Vockley G, Roy-Chowdhury J, Cascalho M, Guha C, Sindhi R, Platt JL, Fox IJ. Host conditioning and rejection monitoring in hepatocyte transplantation in humans. J Hepatol. 2017 May;66(5):987-1000. doi: 10.1016/j.jhep.2016.12.017. Epub 2016 Dec 24. PMID: 28027971