Prevalence, course and impact of HLA donor-specific antibodies in liver transplantation in the first year

T. Taner, M. J. Gandhi, S. O. Sanderson, C. R. Poterucha, S. R. De Goey, M. D. Stegall, J. K. Heimbach

Research output: Contribution to journalArticle

98 Scopus citations

Abstract

The presence of preformed donor-specific HLA antibodies (DSA) in liver transplant recipients is increasingly recognized; however, the prevalence of DSA and their impact on early allograft function remains unknown. We prospectively followed serum DSA levels of 90 consecutive liver transplant recipients from baseline to 4 months. Twenty recipients (22.2%) had preformed DSA. No antibody-targeting treatments were undertaken. Seven days after transplantation, DSA levels decreased markedly in all but three patients. Day 7 protocol biopsies showed diffuse C4d deposition along the portal stroma, central vein, subendothelial and stromal space in the patients with persistent high DSA levels. The rate of acute cellular rejection was not significantly different in patients with DSA. The transaminase and bilirubin levels remained comparable during the first year despite the presence of DSA. The three patients with persistently high DSA levels continue to have normal allograft function. We conclude that in most cases, DSA disappear after liver transplant, however in rare instances where they persist, there is evidence of complement activation in the liver allograft, without significant clinical impact in the first year. Preformed donor-specific antibodies rarely persist after liver transplant and have no significant clinical impact in the first year.

Original languageEnglish (US)
Pages (from-to)1504-1510
Number of pages7
JournalAmerican Journal of Transplantation
Volume12
Issue number6
DOIs
StatePublished - Jun 2012

Keywords

  • Complement C4d
  • HLA antibodies
  • donor-specific antibodies
  • liver transplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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