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 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 |