Preformed antibodies detected by cytotoxic assay or multibead array decrease liver allograft survival: Role of human leukocyte antigen compatibility
- 26 March 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Liver Transplantation
- Vol. 14 (4), 554-562
- https://doi.org/10.1002/lt.21408
Abstract
The significance of human leukocyte antigen (HLA) compatibility and preformed antibodies in liver transplantation remains unclear. The objectives of this study were to evaluate, in a single‐center cohort comprising 896 liver transplants, whether the degree of donor‐recipient compatibility and preformed antibodies modified graft survival. Univariate Kaplan‐Meier analysis demonstrated that donor‐recipient HLA compatibility had a marginal impact on allograft survival. As for compatibility at individual antigen loci, 2 mismatches at HLA‐A conferred a survival advantage in retransplanted allografts (P = 0.011). HLA‐B and HLA‐DR loci did not play a significant role in outcome in any pathology. The concordance of results on preformed antibodies detected by complement‐dependent cytotoxicity (CDC) and a multiple bead assay (Luminex® xMAP) showed a strong correlation between both techniques (P < 0.0001). Both CDC‐detected and Luminex‐detected antibodies were associated with shorter graft survival within the first year post‐transplant (P = 0.01 and P = 0.016, respectively). Positive CDC T crossmatches and Luminex‐detected HLA class II antibodies played a significant role in decreasing graft survival (P = 0.043 and P = 0.0019 at 1 year, respectively, and P = 0.005 and P = 0.038 at 5 years, respectively). A correlation was also observed between the presence of preformed Luminex‐detected class II or Luminex I and II antibodies and allograft rejection (P = 0.001 and P = 0.042, respectively). In conclusion, although HLA typing is not a prerequisite for transplantation, screening of HLA antibodies with Luminex techniques and CDC crossmatch may be useful in the detection of at‐risk patients that could benefit from increased surveillance and tailored therapy following transplantation. Liver Transpl, 2008. © 2008 AASLD.Keywords
This publication has 44 references indexed in Scilit:
- The effect of HLA class I (A and B) and class II (DR) compatibility on liver transplantation outcomes: An analysis of the OPTN databaseLiver Transplantation, 2006
- Impact of human leukocyte antigen matching in liver transplantationTransplantation, 2003
- Liver transplantationJournal of Hepatology, 2000
- IgG DONOR-SPECIFIC CROSSMATCHES ARE NOT ASSOCIATED WITH GRAFT REJECTION OR POOR GRAFT SURVIVAL AFTER LIVER TRANSPLANTATIONTransplantation, 1995
- HLA COMPATIBILITY AND LIVER TRANSPLANT OUTCOME Improved Patient Survival by HLA and Cross-MatchingTransplantation, 1994
- The need for a consensus agreement on indications of liver transplantationHepatology, 1994
- Combined liver-kidney transplantation and the effect of preformed lymphocytotoxic antibodiesTransplant Immunology, 1994
- The Influence of HLA Compatibility on Graft Survival after Heart TransplantationNew England Journal of Medicine, 1994
- THE LACK OF LONG-TERM DETRIMENTAL EFFECTS ON LIVER ALLOGRAFTS CAUSED BY DONOR-SPECIFIC ANTI-HLA ANTIBODIESTransplantation, 1993
- Benefits of HLA-A and HLA-B Matching on Graft and Patient Outcome after Cadaveric-Donor Renal TransplantationNew England Journal of Medicine, 1984