Polymorphisms in genes involved in regulating follicular helper T cell differentiation predict de novo donor-specific antibody formation after liver transplantation.

Background: De novo donor-specific antibodies (dnDSAs) significantly affect the long-term outcomes of liver transplantation (LT), highlighting the importance of risk prediction. Follicular helper T (Tfh) cells have been implicated in dnDSA formation after transplantation. Considering the influence of immune response gene polymorphisms on transplantation outcomes, we investigated the association between polymorphisms in Tfh cell-related genes and dnDSA formation after LT.

Methods: Fifty-three living-donor LT patients were included in this study. Single nucleotide polymorphisms (SNPs) were identified in six Tfh cell-related genes crucial for differentiation and maturation (BCL6, CXCR5, CXCL13, ICOS, CD40L, and IL-21); their association with the development of dnDSA after LT was evaluated.

Results: Among the 53 recipients, 9 developed dnDSAs. BCL6 and IL-21 SNPs showed potential associations with dnDSA formation, enabling risk stratification.

Conclusions: Variations in Tfh cell-related genes may predispose individuals to dnDSA formation after LT, emphasizing the importance of genetic factors for predicting post-transplant complications.