Role of NFKBIA and PTPN22 genes polymorphism in acute rejection susceptibility after living donor liver transplantation in Egyptian patients

Abstract Background Acute cellular rejection (ACR) is a life-threatening event that mostly occurs in the first month after liver transplantation. Genetic polymorphisms in the nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor-alpha (NFKBIA) and protein tyrosine phosphatase non-receptor (PTPN22) genes are linked to organ rejection. Our study aimed to assess whether NFKBIA (rs696;126 G/A) and PTPN22 (rs2476601;1858G/A) gene polymorphisms are associated with ACR in liver transplant (LT) Egyptian recipients. Methods Our study was observational prospective cohort study. The study was conducted on LT Egyptian recipients on immunosuppression to investigate the influence of NFKBIA (rs696;126 G/A) and PTPN22 (rs2476601;1858G/A) gene polymorphism on the incidence of ACR after liver transplantation. Results Our study enrolled ninety-eight patients. Twenty-nine patients experienced ACR, while 69 patients showed no ACR. The homozygous allele (GG) of the PTPN22 (rs2476601;1858G/A) gene had lower rejection episodes when compared with heterozygous genotypes. Higher trough levels of tacrolimus and cyclosporin have shown a lower risk of ACR ( p = 0.044 and p = 0.008), respectively. Conclusion Trough levels of immunosuppressant are not the only predictor for ACR but also genetic polymorphism plays a role. Graphical abstract