Interrelationship between Toll-like receptors and infection after orthotopic liver transplantation

Table 1 Types of infections after orthotopic liver transplantation

	First month post transplant	1-6 mo post transplant	> 6 mo post transplant
Bacterial infections	Staph aurus, Strptoccoi enterococci, Salmonella pseudomonas, MRSA, VRE, Anerobes, Clostridium difficile	Multidrug resistant bacteria, Listeria spp	Multidrug resistant bacteria
Viral	Human herpes virus 6	CMV, HCV, EBV, VZV	HHV8, HEV, EBV, Parvovirus B19
Fungal	Candida, Asprgillus	Mucormucosis, Pneumocystitis jerovicii (PJP)	Nocardia, Rhodococcus, Legionella, Cryptococcus, Blastomycosis, histoplasmosis
Mycobacterial		TB	TB, Non tuberculous Mycobacteria (Mycobacterial avium complex, Myco. triplex)
Protozoal			Strongyloiodosis, toxoplasmosis; Echinococcosis, Chagas disease
Types of infections	Wound infections, Abdominal infections, catheter related infections, pneumonia, UTI, abscess, cholangitis, peritonitis	Community acquired infections, Invasive fungal infection	Community acquired pathogens, Opportunistic infections

CMV: Cytomegalovirus; EBV: Epstein–Barr virus; HBV: Hepatitis B virus; HCV: Hepatitis C virus; HEV: Hepatitis E virus; HHV: Human herpes virus; HIV: Human immune deficiency virus; HSV: Herpes simplex virus; MRSA: Methicillin-resistant Staphylococcus aureus; VRE: Vancomycin-resistant Enterococcus; VZV: Varicella zoster virus.

Table 2 Association of Toll-like receptors alleles with infections post liver transplantation and their clinical significance

Type of Infection	Type of organism	TLR alleles	Clinical significance
Bacterial infections	Staph aurus	TLR2 (Arg753Gln)	Inconclusive association with septic shock
		TLR2 (R753Q)	May correlated only in cases of infections with large dose of pathogen
	Listeria monocytogenes	TLR2/MyD88-dependent pathway	Participate in cytokine cascade No role in clearance
	Salmonella typhimurium	TLR4	Granuloma formation
	Salmonella choleraesuis	TLR2, TLR4	Have role in pathogenesis; No role in clearance
		TLR9	Has role in clearance
Protozoal	Plasmodium falciparum	TLR1, TLR6	Mild form of malaria
		TLR9 (1486 C/T)	Severe form of malaria
Mycobacterium	Mycobaterial tuberculosis	TLR2 (R753Q)	Increased susceptibility to T.B in Turkish
		TLR2 (Arg677Trp)	Increased susceptibility to T.B in Tunisian but not to Iranian and Indian populations.
Viral	Hepatitis C virus (HCV)	TLR2 (Arg753Gln)	Recurrence of HCV post transplant (PT) with higher graft cirrhosis and graft failure
		TLR2 (R753Q)	Higher rate of graft failure
		TLR3	Increased liver fibrosis
		TLR4 (Asp299Gly) and (Thr399Ile)	No associated PT complications
		TLR7/8-mediated pathway	Aggressive PT recurrence of HCV
	Cytomegalovirus (CMV)	TLR2 (R753Q) TLR2 (Arg753Gln)	Increased incidence of CMV PT

TLR: Toll-like receptor.