Abstract
Objective. Presence of anti-HLA antibodies has a well-known impact on kidney grafts survival; however their role in liver transplantation has not been fully elucidated. We conducted a 7-year prospective study to show correlation between presence of anti-HLA and anti-MICA antibodies and liver graft survival. Methods. Blood samples from 123 liver transplant recipients were collected during patients routine visits. Time from transplantation to blood sample collection was different for each patient. Blood samples were tested for anti-HLA (separately class I and II) and MICA antibodies using Luminex assays. Results. There were 32 (26%) patients with positive anti-HLA and 37 (30%) with positive anti-MICA antibodies. Graft loss occurred in 7 cases (23%) in anti-HLA positive group compared to 20 (22%) in anti-HLA negative group (P = ns) and in 8 cases (22%) in anti-MICA positive group but 19 (23%) in anti-MICA negative group (P = ns). No correlations were detected between presence of antibodies and acute graft rejection (AGR). Presence of any antibodies (anti-HLA or anti-MICA antibodies) correlated with late graft rejection (P = 0.04). Conclusion. Presence of anti-HLA or anti-MICA had no impact on long-term liver graft survival; however, detection of any antibodies was correlated with episodes of late graft rejection.
Highlights
Presence of donor specific anti-HLA antibodies (DSA) is a negative predictor of graft survival in kidney transplantation
Anti-HLA and anti-MICA antibody results and full medical reports were available for 123 liver transplant recipients (61 women, 62 men)
Positive correlation between percentage of patients with positive anti-HLA, but not anti-MICA antibodies, and time after transplantation was observed in groups after 2nd posttransplant year
Summary
Presence of donor specific anti-HLA antibodies (DSA) is a negative predictor of graft survival in kidney transplantation. Antibody mediated rejection (AMR) of liver graft has not been considered an important pathology in ABO compatible, cross-match negative liver transplantation for many years. Evidence for pathological role of high-titre antibodies to class I antigen in the vanishing bile duct syndrome after liver transplantation was described by Donaldson et al 25 years ago [3]. Presence of preformed antibodies against donor HLA antigens detected by cytotoxic assay or multibead array was associated with decreased 1- and 5-year liver graft survival [4]. AMR cases in AB0-compatible, cross-match negative liver transplants with presence of anti-HLA antibodies have been described with graft function improvement after therapeutic depletion of anti-HLA antibodies titer [5, 6]
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