Significance of preformed anti-donor antibodies in liver transplantation

Shiro Fujita, Charles Rosen, Alan Reed, Max R. Langham, Richard J. Howard, Gregory Y. Lauwers, Juan C. Scornik

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12 Scopus citations

Abstract

The significance of a positive cross-match in liver transplantation remains controversial, as documented by a number of recent conflicting reports. In this study, we evaluated 195 consecutive orthotopic liver transplant recipients in whom the cross-match was either negative or positive for T or B cells. Special emphasis was placed on the outcome of patients with high levels of preformed IgG antibodies directed against donor T cells. IgG anti-donor antibodies were confirmed by flow cytometry in all cases. Of 10 patients with strong T-cell antibodies, there was one early death due to nonimmunological causes. Transplantation was successful in 9/10 patients followed for 3 months to 3 years. Graft survival, incidence of acute rejection, and number of liver biopsies in patients with a positive cross-match (strong T, weak T, or B cell) were not significantly different from those of patients with a negative cross-match. In the strong T cell antibody group, one patient had early graft dysfunction, with extensive hepatic necrosis and histological signs of antibody-induced damage. Two other patients also showed some evidence of possible antibody-mediated events, such as neutrophil infiltration and hepatocyte swelling. These lesions were reversible, and the patients had uneventful recoveries. Thus, in our experience, preformed antibodies did not preclude good graft survival.

Original languageEnglish (US)
Pages (from-to)84-88
Number of pages5
JournalTransplantation
Volume63
Issue number1
DOIs
StatePublished - Jan 15 1997
Externally publishedYes

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ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Fujita, S., Rosen, C., Reed, A., Langham, M. R., Howard, R. J., Lauwers, G. Y., & Scornik, J. C. (1997). Significance of preformed anti-donor antibodies in liver transplantation. Transplantation, 63(1), 84-88. https://doi.org/10.1097/00007890-199701150-00016