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The impact of preformed donor-specific antibodies in living donor liver transplantation according to graft volume
| Title: | The impact of preformed donor-specific antibodies in living donor liver transplantation according to graft volume |
| Authors: | Goto, Ryoichi Browse this author →KAKEN DB | | Ito, Makoto Browse this author | | Kawamura, Norio Browse this author →KAKEN DB | | Watanabe, Masaaki Browse this author | | Ganchiku, Yoshikazu Browse this author | | Kamiyama, Toshiya Browse this author →KAKEN DB | | Shimamura, Tsuyoshi Browse this author →KAKEN DB | | Taketomi, Akinobu Browse this author →KAKEN DB |
| Keywords: | GV/SV ratio | | left hepatic lobe | | lymphocyte crossmatch test | | pre-transplantation | | small for size graft |
| Issue Date: | Mar-2022 |
| Publisher: | John Wiley & Sons |
| Journal Title: | Immunity, inflammation and disease |
| Volume: | 10 |
| Issue: | 3 |
| Start Page: | e586 |
| Publisher DOI: | 10.1002/iid3.586 |
| Abstract: | Introduction: The roles of preformed anti-HLA donor-specific antibodies (DSAs) in liver transplantation remain controversial. We evaluated the impact of preformed DSAs in living donor liver transplantation. Methods: Adults who underwent living donor liver transplantation (n = 175) in our institute were included in this study. Lymphocyte cytotoxicity test (LCT), flow cytometric crossmatch (FCXM), and single-antigen bead assays were performed. Results: Among adult living donor liver transplantation recipients, 27 (16.5%) and 14 (8.5%) had pretransplant FCXM-positive findings and LCT-positive findings, respectively. FCXM-positive patients displayed a significantly worse 5-year graft survival rate (77.3%; vs. DSA-negative, 91.6%). Six of 14 LCT-positive patients exhibited graft loss shortly after transplantation (5-year survival rate: 57.1%). All LCT-positive patients with graft loss underwent left lobe living donor liver transplantation. Significantly lower ratio of graft volume relative to standard liver volume (32.9 +/- 5.7%) and smaller graft size (365.3 +/- 57.9 g) were observed in patients with graft loss (p<.03, vs. surviving grafts). Significantly higher DSA-mean fluorescence intensity (MFI) values were present in patients with graft loss (p=.0012, vs. surviving grafts). Conclusions: Patients with preformed DSAs exhibited worse graft outcomes in living donor liver transplantation. Higher DSA-MFI values and smaller graft size were associated with worse outcomes in LCT-positive patients. High-risk patients with preformed DSAs should be considered for appropriate graft selection and application of a desensitization protocol. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/84263 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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