Abstract：
BACKGROUND:The role of histocompatibility between donor and recipient in liver transplant rejection is unclear because of a paucity of data. The influence of human leukocyte antigen (HLA) type on immunologic graft loss was examined for primary liver transplantations performed at this center. METHODS:Immunologic graft loss included patient death or retransplantation as a result of rejection or impending graft loss caused by either late hepatic artery thrombosis or severe, unremitting rejection requiring FK 506 rescue therapy. HLA A, B, and DR matching was available on 205 donor-recipient combinations, and an additional 31 patients had A and B matching only. RESULTS:A mismatch of class I antigens (HLA A and B) was predictive of immunologic graft loss (p = 0.018). DR mismatch did not correlate with graft loss. When the A and B loci were analyzed separately, an A mismatch correlated significantly with immunologic graft loss (p = 0.02), in contrast to a B mismatch (p = 0.17). Better matching significantly improved patient survival (p = 0.02) and overall graft survival (p = 0.009). CONCLUSIONS:The beneficial effect of HLA class I antigen compatibility on liver transplantation outcome is in contrast to pancreatic and kidney transplantation in which class II antigen matching but not class I matching is beneficial. Immunologic mechanisms of hepatic allograft rejection may differ from those involved in kidney transplant rejection.
journal_name
Surgeryjournal_title
Surgeryauthors
Knechtle SJ,Kalayolu M,D'Alessandro AM,Mason B,Pirsch JD,Sollinger HW,Steen DC,Belzer FOsubject
Has Abstractpub_date
1993-10-01 00:00:00pages
667-71; discussion 671-2issue
4eissn
0039-6060issn
1532-7361pii
0039-6060(93)90253-Ajournal_volume
114pub_type
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