12 September 2023 : Original article
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
1ABCDEF*, Kei Tamura 1AB, Katsunori Sakamoto 1C, Naotake Funamizu 1B, Masahiko Honjo 1B, Mikiya Shine1B, Yusuke Nishi1B, Tomoyuki Nagaoka 1B, Chihiro Ito1B, Miku Iwata1B, Mio Uraoka1B, Yasutsugu Takada 1AD
DOI: 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. | ||||