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Hepatitis B Immunoglobulins Inhibit Dendritic Cells and T Cells and Protect Against Acute Rejection After Liver Transplantation

The efficacy of anti‐viral intravenous immunogobulins (anti‐HBs Ig and anti‐CMV Ig) in preventing acute rejection after liver transplantation was assessed in a retrospective analysis, and correlated to their effects on immune cells in vitro. HBs Ag‐positive liver graft recipients (n = 40) treated prophylactically with anti‐HBs Ig had a significantly lower incidence of acute rejection compared with recipients without viral hepatitis (n = 147) (12% vs. 34%; p = 0.012), while the incidence of rejection in HCV‐positive recipients (n = 29) was similar to that in the control group. Treatment with anti‐CMV Ig (n = 18) did not protect against rejection. In vitro, anti‐HBs Ig suppressed functional maturation of and cytokine production by human blood‐derived dendritic cells (DC) at concentrations similar to the serum concentrations reached during anti‐HBs Ig treatment of liver graft recipients. In addition, anti‐HBs Ig inhibited allo‐antigen‐ and lectin‐stimulated proliferation of peripheral T cells. Anti‐CMV Ig suppressed functional DC‐maturation and alloantigen‐stimulated T‐cell proliferation, but not lectin‐driven T‐cell proliferation.