Preformed antibodies detected by cytotoxic assay or multibead array decrease liver allograft survival: Role of human leukocyte antigen compatibility
✍ Scribed by Marcela Castillo-Rama; Maria Jose Castro; Ivan Bernardo; Juan Carlos Meneu-Diaz; Almudena Moreno Elola-Olaso; Sara M. Calleja-Antolin; Eva Romo; Pablo Morales; Enrique Moreno; Estela Paz-Artal
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 140 KB
- Volume
- 14
- Category
- Article
- ISSN
- 1527-6465
- DOI
- 10.1002/lt.21408
No coin nor oath required. For personal study only.
✦ Synopsis
The significance of human leukocyte antigen (HLA) compatibility and preformed antibodies in liver transplantation remains unclear. The objectives of this study were to evaluate, in a single-center cohort comprising 896 liver transplants, whether the degree of donor-recipient compatibility and preformed antibodies modified graft survival. Univariate Kaplan-Meier analysis demonstrated that donor-recipient HLA compatibility had a marginal impact on allograft survival. As for compatibility at individual antigen loci, 2 mismatches at HLA-A conferred a survival advantage in retransplanted allografts (P ϭ 0.011). HLA-B and HLA-DR loci did not play a significant role in outcome in any pathology. The concordance of results on preformed antibodies detected by complement-dependent cytotoxicity (CDC) and a multiple bead assay (Luminexா xMAP) showed a strong correlation between both techniques (P Ͻ 0.0001). Both CDC-detected and Luminex-detected antibodies were associated with shorter graft survival within the first year post-transplant (P ϭ 0.01 and P ϭ 0.016, respectively). Positive CDC T crossmatches and Luminex-detected HLA class II antibodies played a significant role in decreasing graft survival (P ϭ 0.043 and P ϭ 0.0019 at 1 year, respectively, and P ϭ 0.005 and P ϭ 0.038 at 5 years, respectively). A correlation was also observed between the presence of preformed Luminex-detected class II or Luminex I and II antibodies and allograft rejection (P ϭ 0.001 and P ϭ 0.042, respectively). In conclusion, although HLA typing is not a prerequisite for transplantation, screening of HLA antibodies with Luminex techniques and CDC crossmatch may be useful in the detection of at-risk patients that could benefit from increased surveillance and tailored therapy following transplantation.