The Influence of AbIGA Antibodies as a Vascular Complication Marker in Liver Transplantation

Abstract

Introduction The presence of pretransplant AbIGA is one of the factors associated with the highest risk of thrombosis and graft loss in patients who have received either kidney or heart transplantation, without any evidence of impact in orthotopic liver transplant (OLT). Vascular complications are a serious setback both in patients who are candidates for liver transplantation and probably in post-transplant patients. The aim of this study is to evaluate whether the presence of these antibodies (Ab) is related to those vascular complications in OLT recipients. Methods We have performed a comparative retrospective analysis of transplanted patients with antibodies studies between March 2000 and June 2013. Subgroups were established as follows: group A included patients who were positive for AbIGA antibodies (+) while group B included patients with negative results (-). Results We have compared the clinical characteristics of patients in group A vs group B, not obtaining statistically significant results in terms of age (54 years ± 10,1 vs 52 years ± 11,5, p=NS), body mass index (BMI) ( 27,1 vs 26,5, p=NS), MELD score (group A 15,49 vs group B 16,45, p=NS), presence of hepatocellular carcinoma (HCC) (22,3% vs 19,8% p=NS) or hepatitis C virus (HCV) infection (47,0% vs 44,2% p=NS). Statistically significant differences were found concerning transfusion requirements, as Ab (+) patients were shown to have received a higher number of red blood cell transfusions (9± 9,0 vs 6± 5,1, p=0,001). No statistically significant differences were found regarding vascular complications, that is pretransplantation portal vein thrombosis (PVT) (15,8% vs 10,5%, p=0,46), post-transplant hepatic artery thrombosis (4,2% vs 2,3%, p=0,5), and post-transplant PVT (1,4% vs 0%, p=0,27). Patient survival rate at 1, 3, and 5 years was 82,9%, 76% and 68,9% respectively in group A, vs 84,9%, 72,1% y 66,3% in group B; no significant differences were found (p=0,370.) Conclusion The presence of AbIGA (+) in OLT patients is not associated with a higher incidence of vascular complications compared to those OLT patients with AbIGA (-).