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 2 Clinical features and outcomes of donor-specific anti-human leukocyte antigen antibody (DSA)-positive liver transplant recipients.
| Case | Primary disease | Sex | Age (y) | Donor | Blood type combination | Lymphocyte cross-match | Maximum MFI of DSA class I | Maximum MFI of DSA class II |
|---|---|---|---|---|---|---|---|---|
| 1 | LC (AIH) | F | 64 | Son | Identical | T cell: positiveB cell: positive | A31: 9514 | DR12: 9909 |
| 2 | LC (Alcohol) | F | 57 | Daughter | Identical | T cell: positiveB cell: positive | B13: 12041 | DR12: 15336 |
| 3 | LC (HCV) | M | 52 | Nephew | Incompatible | T cell: negativeB cell: positive | – | DQ6: 11620 |
| 4 | PBC | F | 59 | Brother | Identical | T cell: positiveB cell: positive | B44: 8044 | – |
| 5 | PSC | F | 50 | Daughter | Identical | T cell: positiveB cell: positive | – | DQ6: 1981 |
| 6 | LC (HCV) | F | 59 | Son | Compatible | T cell: negativeB cell: positive | – | DR8: 2988 |
| 7 | LC (Alcohol) | M | 37 | Brother | Compatible | T cell: positiveB cell: positive | – | DR4: 1644 |
| 8 | LC (AIH) | F | 67 | Niece | Incompatible | T cell: negativeB cell: negative | A2: 1078 | – |
| 9 | PBC | F | 67 | Son | Identical | T cell: negativeB cell: negative | – | DR4: 1982 |
| 1 | A74: 9308 | Rituximab, tacrolimus, MMF | Yes | None | None | Alive (889) | ||
| 2 | DQ7: 11093 | Rituximab, tacrolimus, MMF | Yes | TCMR | None | Alive (567) | ||
| 3 | – | Rituximab, tacrolimus, MMF | Yes | TCMR, AMR | CMV | Alive (987) | ||
| 4 | B42: 5173 | MMF | No | None | None | Alive (2415) | ||
| 5 | – | MMF | Yes | None | None | Alive (1897) | ||
| 6 | B54: 13471 | MMF | Yes | None | None | Alive (973) | ||
| 7 | B62: 1772 | None (due to SBP) | No | None | None | Alive (1169) | ||
| 8 | – | Rituximab, tacrolimus, MMF | Yes | None | CMV | Alive (1239) | ||
| 9 | – | none | No | None | None | Alive (518) | ||
| MFI – mean fluorescence intensity; DSA – donor-specific anti-human leukocyte antigen antibody; CREG – cross-reactive epitope group; IVIG – intravenous immune globulin; LC – liver cirrhosis; AIH – auto-immune hepatitis; MMF – mycophenolate mofetil; TCMR – T-cell mediated rejection; HCV – hepatitis C virus; AMR – antibody mediated rejection; CMV – cytomegalovirus infection; PBC – primary biliary cholangitis; N/A – not applicable; PSC – primary sclerosing cholangitis; SBP – spontaneous bacterial peritonitis. | ||||||||