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Effect of donor-specific antibodies and panel reactive antibodies in living donor liver transplant recipients

 Seung Hwan Song  ;  Myoung Soo Kim  ;  Jung Jun Lee  ;  Man Ki Ju  ;  Jae Geun Lee  ;  Juhan Lee  ;  Jin Sub Choi  ;  Gi Hong Choi  ;  Soon Il Kim  ;  Dong Jin Joo 
 Annals of Surgical Treatment and Research, Vol.88(2) : 100-105, 2015 
Journal Title
 Annals of Surgical Treatment and Research 
Issue Date
Acute rejection ; Donor specific antibody ; Graft survival ; Liver transplantation ; Sensitization
PURPOSE: Preformed circulating donor-specific antibodies (DSAs) immunologically challenge vascular endothelium and the bile duct. However, the liver is an immune-tolerant organ and can avoid immunological challenges. This study was undertaken to analyze the effects of DSAs after adult living donor liver transplantation (LDLT). METHODS: We retrospectively reviewed 219 LDLT patients' records treated at our center. RESULTS: Of the 219 patients, 32 (14.6%) were DSA (+) and 187 (85.4%) were DSA (-). Class I DSAs were present in 18 patients, class II in seven patients, and both in seven patients. Seven patients (3.2%) showed DSA to HLA-A, four (1.8%) to HLA-B, seven (3.2%) to HLA-DR, and 14 (6.4%) to two or more HLAs. More DSAs were observed in female recipients than male recipients in the DSA (+) group. The DSA (+) group showed significantly higher levels of class I and II panel reactive antibody (PRA) than did the DSA (-) group. No significant intergroup differences were found between incidences of primary nonfunction, acute rejection, vascular complication, or biliary complication. There were no significant differences in graft survival rates between the two groups. However, the recipients with multiple DSAs tended to have more acute rejection episodes and events of biliary stricture and lower graft survival rates than did patients in the DSA (-) group. CONCLUSION: In LDLT, the presence of multiple DSAs and high PRA seemed to be associated with poor graft outcomes, although our results did not reach statistical significance. Large cohort studies are necessary to clarify the impact of DSA and PRA in LDLT.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Lee, Ju Han(이주한)
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Joo, Man Ki(주만기) ORCID logo https://orcid.org/0000-0002-4112-7003
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
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