12 September 2023>: Original Paper
Living Donor Liver Transplantation in Patients with Preformed Donor-Specific Anti-Human Leukocyte Antigen Antibodies Using Preoperative Desensitization Therapy According to Intensity of Donor-Specific Antibodies: A Single-Center Study
Kohei Ogawa ABCDEF* , Kei Tamura AB , Katsunori Sakamoto C , Naotake Funamizu B , Masahiko Honjo B , Mikiya Shine B , Yusuke Nishi B , Tomoyuki Nagaoka B , Chihiro Ito B , Miku Iwata B , Mio Uraoka B , Yasutsugu Takada ADDOI: 10.12659/AOT.941346
Ann Transplant 2023; 28:e941346
Table 1 Characteristics of the 37 living donor liver transplant recipients since 2016.
Variable | All patients (n=37) | Anti-HLA antibody | ||
---|---|---|---|---|
Negative (n=12) | Positive (n=25) | p-value | ||
Age, median (range), y | 54 (24–70) | 54 (31–69) | 57 (20–69) | 0.95 |
Sex, n, male/female | 17/20 | 9/3 | 8/17 | |
Primary disease, n | LC: 21 | LC (HBV): 3 | LC (HCV): 5 | 0.37 |
ALF: 3 | LC (HCV): 2 | LC (Alcohol): 4 | ||
PBC: 3 | LC (Alcohol): 2 | LC (AIH): 3 | ||
BA: 3 | LC (NASH): 2 | LC (HBV): 2 | ||
AIH: 3 | BA: 2 | LC (NASH): 1 | ||
graft failure: 1 | other: 1 | ALF: 3 | ||
other: 3 | PBC: 3 | |||
graft failure: 1 | ||||
BA: 1 | ||||
Other: 2 | ||||
Blood transfusion, n (%) | 21 (57) | 8 (67) | 13 (52) | 0.40 |
Pregnancy, n (%) | 15 | 2 (17) | 13 (52) | |
Previous transplant | 1 (3) | 0 | 1 (4) | 0.48 |
Donors, n | Child: 15 | Child: 5 | Child: 10 | 0.73 |
Sibling: 12 | Sibling: 4 | Sibling: 8 | ||
Spouse: 4 | Spouse: 2 | Spouse: 2 | ||
Parent: 3 | Parent: 1 | Parent: 2 | ||
Other: 3 | Other: 3 | |||
Anti-HLA antibody, n (%) | 25 (68) | – | 25 (100) | |
Class I only, n (%) | 7 (19) | – | 7 (28) | |
Class II only, n (%) | 5 (14) | – | 5 (20) | |
Class I & Class II, n (%) | 13 (35) | – | 13 (52) | |
DSA positive, n (%) | 9 (24) | – | 9 (36) | |
CREG positive, n (%) | 12 (32) | – | 12 (48) | |
HLA – human leukocyte antigen; LC – liver cirrhosis; ALF – acute liver failure; PBC – primary biliary cirrhosis; BA – biliary atresia; AIH – auto-immune hepatitis; HBV – hepatitis B virus; HCV – hepatitis C virus; NASH – non-alcoholic steatohepatitis; DSA – donor-specific anti-human leukocyte antigen antibody; CREG – cross-reactive epitope group. |