Abstract:
:The relevance of pre-existing HLA-antibodies (HLA-Ab) in liver transplantation (LTx) is controversial. While livers are allocated without HLA match or preoperative crossmatch testing, several studies point to an impact of donor specific antibodies (DSA) for acute rejection, bile duct complications or even graft loss. To investigate the role of DSA in long term liver allograft survival we analysed 177 pre transplant sera of first LTx patients with Luminex single antigen technology defining a MFI of >1500 as positive. The analyses were done retrospectively, and the DSA results had no impact on graft acceptance or patients' therapy. Three year follow up was available for all patients. 77% of our patients had any HLA-Ab pre transplantation, 55 patients were transplanted with DSA by chance. Acute rejections or ischemic type bile duct lesions (ITBL) were not higher in the DSA group, but ITBL was associated with a higher donor age. There was no difference in long term graft function or survival in patients without HLA-Ab, with non DSA or with DSA (p = 0.712). We suggest that determination of pre-existing DSA in first LTx recipients is not appropriate and we conclude that pre-existing DSA in first LTx patients are not a contraindication for liver transplantation.
journal_name
Hum Immunoljournal_title
Human immunologyauthors
Koch M,Marget M,Sterneck M,Fischer L,Thude H,Nashan Bdoi
10.1016/j.humimm.2018.04.009subject
Has Abstractpub_date
2018-07-01 00:00:00pages
545-549issue
7eissn
0198-8859issn
1879-1166pii
S0198-8859(18)30116-2journal_volume
79pub_type
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