Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

17 September 2015 : Original article  

Effects of Preoperative Positive Cross-Match and HLA Mismatching on Early Acute Cellular Rejection and Graft Survival in Living Donor Liver Transplantation

Gun Hyung NaABCDEF, Eun Young KimB, Tae Ho HongAD, Young Kyoung YouAD, Dong Goo KimACDF

DOI: 10.12659/AOT.894466

Ann Transplant 2015; 20:553-560

Abstract

BACKGROUND: We evaluated the effects of preoperative positive cross-match and HLA mismatching on early acute cellular rejection and graft survival in living donor liver transplantation (LDLT).

MATERIAL AND METHODS: We retrospectively reviewed data of 286 patients who underwent LDLT from 2008 to 2013. Cross-matching tests were performed by complement-dependent lymphocytotoxicity (CDC) and flow cytometry (FCX) methods. The CDC cross-matching test was performed using the National Institutes of Health (NIH) standard cross-match and antiglobulin (AHG) cross-match methods.

RESULTS: NIH, AHG, and FCX were positive in T-lymphocytes from 18 (6.3%), 21(7.3%), and 23 (8.0%) patients, respectively. T-CDC (T-NIH or T-AHG) results were positive in 23 (8.0%) patients. CDC and FCX results were positive in B-lymphocytes from 18 (6.3%) and 35 (12.2%) patients. All positive cross-match results were significantly associated with acute cellular rejection. Only a positive T-CDC cross-match was significantly associated with decreased graft survival (P=0.035). In a multivariate analysis, a positive T-CDC cross-match was the only independent risk factor with a decreased graft survival rate (P=0.041). An HLA mismatch was not associated with acute rejection (p=0.468 for HLA-A, p=0.644 for HLA-B, and p=0.811 for HLA-DR), graft survival (p=0.895 for HLA-A, p=0.580 for HLA-B, and p=0.969 for HLA-DR), and overall survival (p=0.862 for HLA-A, p=0.634 for HLA-B, and p=0.917 for DLA-DR).

CONCLUSIONS: Although a further prospective study with a larger cohort is required, it is not wise nor safe to perform LDLT in the setting of a positive T-CDC cross-match result.

Keywords: Blood Grouping and Crossmatching, Graft Rejection, Graft Survival, Histocompatibility Testing, Liver Transplantation

Add Comment 0 Comments

In Press

Original article  

The Long-Acting Glucagon-Like Peptide-2 Analog Apraglutide Enhances Intestinal Protection and Survival Afte...

Ann Transplant In Press; DOI: 10.12659/AOT.945249  

Original article  

Biopsychosocial Effects of Donor Traits on Heart Transplant Recipients

Ann Transplant In Press; DOI:  

Clinical Research  

Ten-Year Retrospective Analysis of Continuous Renal Replacement Therapy in Burn Patients: Impact on Surviva...

Ann Transplant In Press; DOI:  

Original article  

Factors Influencing Stress Disorders in Intensive Care Unit (ICU) Patients After Liver Transplantation: A C...

Ann Transplant In Press; DOI: 10.12659/AOT.944320  

Most Viewed Current Articles

05 Apr 2022 : Original article   13,113

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

22 Nov 2022 : Original article   10,260

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

12 Jan 2022 : Original article   9,611

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

15 Mar 2022 : Case report   7,271

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358