PMID- 12544885
OWN - NLM
STAT- MEDLINE
DCOM- 20030206
LR  - 20211203
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 75
IP  - 1
DP  - 2003 Jan 15
TI  - Impact of human leukocyte antigen matching in liver transplantation.
PG  - 132-7
AB  - BACKGROUND: Human leukocyte antigen (HLA) compatibilities are beneficial in the 
      setting of kidney transplantation but have demonstrated inconclusive results 
      after liver transplantation. On the basis of recent controversial reports, the 
      authors analyzed the impact of HLA matching in their patients after liver 
      transplantation under modern immunosuppressive drug regimens and new HLA typing 
      techniques with respect to outcome and adverse immunologic events. METHODS: Data 
      from 924 transplants with complete donor-recipient HLA typing were 
      retrospectively analyzed. Immunosuppression was commenced as either cyclosporine 
      A- or tacrolimus-based therapy in different protocols. The follow-up period 
      ranged from 1 to 144.8 months (median, 66 months). RESULTS: The actuarial graft 
      survival was 88% after 1 year and 78.7% after 5 years and was similar in 
      tacrolimus- and cyclosporine A-treated patients. However, cyclosporine A-treated 
      patients underwent significantly more rejection episodes. The number of HLA 
      compatibilities had no influence on graft survival, whereas the number of acute 
      rejections was significantly less in transplants with more HLA compatibilities 
      (P<0.05). Graft survival tended to be improved in patients with chronic hepatitis 
      B and more HLA compatibilities (P=0.05). In contrast, graft survival in 
      transplants for primary sclerosing cholangitis was significantly impaired in the 
      presence of one or two HLA-DR compatibilities (P<0.05). In addition, in 
      autoimmune hepatitis, survival tended to be lower in the presence of more HLA 
      compatibilities (P=0.1). Overall graft survival or frequency of adverse 
      immunologic events was not influenced by any specific donor-recipient HLA allele. 
      CONCLUSION: This study demonstrated fewer acute rejections in transplants with 
      more HLA compatibilities. However, in liver transplantation, a more specific 
      investigation of HLA typing may be necessary, because in some indications HLA 
      antigens play a role in the nature of the disease. Therefore, recurrence of 
      autoimmune disease may be more severe in patients sharing HLA antigens.
FAU - Neumann, Ulf P
AU  - Neumann UP
AD  - Chirurgische Klinik und Poliklinik, Charite, Campus Virchow-Klinikum, Humboldt 
      Universitat zu Berlin, Berlin, Germany. ulf.neumann@charite.de
FAU - Guckelberger, Olaf
AU  - Guckelberger O
FAU - Langrehr, Jan M
AU  - Langrehr JM
FAU - Lang, Martina
AU  - Lang M
FAU - Schmitz, Volker
AU  - Schmitz V
FAU - Theruvath, Tom
AU  - Theruvath T
FAU - Schonemann, Constanze
AU  - Schonemann C
FAU - Menzel, Stephan
AU  - Menzel S
FAU - Klupp, Jochen
AU  - Klupp J
FAU - Neuhaus, Peter
AU  - Neuhaus P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Graft Rejection
MH  - Graft Survival
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Immunosuppression Therapy
MH  - Infant
MH  - Liver Transplantation/*immunology
MH  - Male
MH  - Middle Aged
EDAT- 2003/01/25 04:00
MHDA- 2003/02/07 04:00
CRDT- 2003/01/25 04:00
PHST- 2003/01/25 04:00 [pubmed]
PHST- 2003/02/07 04:00 [medline]
PHST- 2003/01/25 04:00 [entrez]
AID - 10.1097/00007890-200301150-00024 [doi]
PST - ppublish
SO  - Transplantation. 2003 Jan 15;75(1):132-7. doi: 10.1097/00007890-200301150-00024.