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 5 Comparisons of donor-specific anti-human leukocyte antigen antibody (DSA)-positive liver transplant recipients by time period.
| Variable | DSA-positive cases | ||
|---|---|---|---|
| 2001–2015 (n=8) | 2016 onwards (n=9) | p-value | |
| Age, median (range), y | 56 (26–61) | 59 (37–67) | 0.37 |
| Sex, n, male/female | 0/8 | 2/7 | 0.16 |
| MELD score, median (range) | 22 (12–30) | 15 (9–28) | 0.09 |
| Primary disease, n | PBC: 4 | PBC: 2 | 0.26 |
| LC (HBV): 1 | LC (HCV): 2 | ||
| LC (HBV, HCV): 1 | LC (AIH): 2 | ||
| LC (alcohol): 1 | LC (alcohol): 2 | ||
| graft failure: 1 | PSC: 1 | ||
| ABO-incompatible, n (%) | 1 (13) | 2 (22) | 0.60 |
| DSA (Class I), n (%) | 2 (25) | 4 (44) | 0.40 |
| MFI, median (range) | 10848 (3194–18502) | 8779 (1078–12041) | 0.80 |
| DSA (Class II), n (%) | 8 (100) | 7 (78) | 0.16 |
| MFI, median (range) | 3775 (1238–15236) | 2988 (1644–17989) | 0.61 |
| Cross-match positive, n (%) | 6 (75) | 7 (78) | 0.51 |
| Preoperative desensitization therapy, n (%) | 1 (13) | 7 (78) | |
| Donor age, median (range), y | 35 (21–56) | 33 (24–64) | 0.89 |
| Graft type, n, Right/Left | 3/5 | 7/2 | 0.09 |
| GRWR, median (range), % | 0.94 (0.73–1.88) | 0.99 (0.79–1.32) | 1.00 |
| Operative time, median (range), min | 804 (655–1065) | 647 (551–909) | |
| CIT, median (range), min | 77 (25–174) | 57 (30–110) | 0.32 |
| WIT, median (range), min | 40 (23–64) | 53 (32–63) | 0.11 |
| Blood loss, median (range), g | 9260 (3130–22445) | 3400 (850–21064) | 0.06 |
| TCMR, n (%) | 4 (50) | 2 (22) | 0.23 |
| AMR, n (%) | 1 (13) | 1 (11) | 0.93 |
| CMV infection, n (%) | 0 | 2 (22%) | 0.16 |
| Bacteremia, n (%) | 3 (38) | 0 | |
| Complications CD IIIb, n (%) | 5 (63) | 1 (11) | |
| 90-day mortality, n (%) | 4 (50) | 0 | |
| OS 1-year, % | 50 | 100 | |
| 3-year, % | 50 | 100 | |
| 5-year, % | 50 | 100 | |
| Follow-up, median (range), days | 1580 (11–7756) | 987 (518–2415) | 1.00 |