A novel method to quantify the immune status and regulate the immunosuppressants in liver transplant recipients

Background: Due to the lack of a reliable means to evaluate the immune status, we proposed a novel method, namely Mingdao immune cells analysis and Mingdao immune score system, to quantify the immunity by scores. Methods: Data from healthy controls in addition to liver transplant recipients, who underwent a single liver transplant or were followed up at Beijing Chaoyang Hospital, were retrospectively collected and analyzed between January 2017 and June 2020. Furthermore, peripheral blood was taken for flow cytometric measurement. Results: A total of 376 healthy controls with 376 tests and 148 liver transplant recipients with 284 tests were included in this study. Evaluated by Mingdao immune cells analysis and Mingdao immune score system, the mean values of healthy controls were near zero inspite of different age groups and gender in contrast to negative mean values in liver transplant recipients before and after liver transplantation. The preoperative scores were used to decide the first dose of the immunosuppressants as patients with lower scores (≤ -5) were suggested to give a lower dose in an attempt to reach a balance between over- and under- immunosuppression. Moreover, we found positive scores or increased scores (≥ 5) could reflect immune activation. Finally, the score was defined to be the only significant independent risk factor for clinical acute rejection (odds ratio, 0.913; confidence interval, 0.845-0.987; P = 0.021). Conclusion: The novel method could be used as an indicator to reflect the immunity and to regulate the immunosuppressants.