Abstract
Donor-specific antibodies in liver transplantation
Highlights
Liver transplantation (LT) remains currently the most successful treatment for end-stage liver disease
The result is expressed as a panel reactive antibody (PRA) value, defined as the percentage of cells in the panel that give a positive reaction with serum.[32]
To explain this relative resistance to humoral responses, in addition to the unique liver characteristics raised earlier, it was suggested that liver allografts were able to release soluble class I major histocompatibility complex (MHC) antigens into the recipient circulation and that these antigens could form immune complexes with anti-class I donor-specific antibodies (DSA) which would eventually be absorbed and cleared by Küpffer cells (KC).[41]
Summary
Liver transplantation (LT) remains currently the most successful treatment for end-stage liver disease. Human liver allografts have been considered to be more resilient to antibody-mediated damage compared to heart or kidney allografts.[40] To explain this relative resistance to humoral responses, in addition to the unique liver characteristics raised earlier, it was suggested that liver allografts were able to release soluble class I MHC antigens into the recipient circulation and that these antigens could form immune complexes with anti-class I DSA which would eventually be absorbed and cleared by KC.[41] These cells were suspected to exert other effects that could enhance the hepatic resistance to AMR, such as phagocytosis of activated platelets and complement components.[42] as mentioned above, the liver exhibits a limited distribution of HLA class II expression under stable conditions. Class/subclass/complement- Persistence binding capacity (cutoff MFI after LT (MFI values)
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