Abstract
BackgroundThe importance of donor-specific antibodies (DSA) after liver transplantation (LT) for graft and patient survival is an ongoing controversy. So far it has not been elucidated when and in how far DSA are harmful for graft and patient survival. Therefore, we had the aim to investigate the association of DSA with complications after LT.MethodsData of 430 LT recipients were collected and statistically analyzed. Detection of HLA antibodies (Ab) was performed by Luminex assay.ResultsDSA were detected in 81 patients (18.8%). These were mainly HLA class II Ab (81.5%). HLA class II Ab show a higher MFI (median: 5.300) compared to HLA class I Ab (median: 2.300). There is no association between MFI levels and development of complications after LT. However, cirrhosis occurred significantly more often in DSA positive patients (18%) than in patients without detectable DSA (9%, P = 0.027). All DSA positive patients with cirrhosis of the graft showed HLA class II antibodies (OR: 3.028; 95% CI: 1.51–6.075; P = 0.002).ConclusionOccurrence of HLA class II DSA after LT is associated with graft cirrhosis and may indicate a higher risk to develop graft damage independent on MFI and requires an individualized risk management.
Highlights
The importance of donor-specific antibodies (DSA) after liver transplantation (LT) for graft and patient survival is an ongoing controversy
Positive patients with human leukocyte antigen (HLA) class II antibodies we found that HLA classes were not associated with the occurrence of complications in general, we were especially interested in their influence on graft cirrhosis
Two of Discussion The present study investigated whether certain DSA classes or the mean fluorescence intensity (MFI) of DSA affects the occurrence of any transplant-related complications after LT
Summary
The importance of donor-specific antibodies (DSA) after liver transplantation (LT) for graft and patient survival is an ongoing controversy. It has not been elucidated when and in how far DSA are harmful for graft and patient survival. This “liver tolerance effect” privileges liver transplant patients to require less immunosuppression in the maintenance setting than recipients of other organs and to be at less risk for episodes of hyperacute rejection [5, 6]. Süsal et al reported that among renal transplant patients preactivated T cells are necessary for DSA to exert a deleterious effect; among these patients, soluble CD30 was found to be an activation marker [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
