PMID- 16315307
OWN - NLM
STAT- MEDLINE
DCOM- 20060314
LR  - 20061115
IS  - 1527-6465 (Print)
IS  - 1527-6465 (Linking)
VI  - 11
IP  - 12
DP  - 2005 Dec
TI  - The effect of HLA mismatches, shared cross-reactive antigen groups, and shared 
      HLA-DR antigens on the outcome after pediatric liver transplantation.
PG  - 1541-9
AB  - The aim of this study was to analyze the effect of human leukocyte antigen (HLA) 
      class I and HLA-DR mismatching, sharing cross-reactive antigen groups (CREGs), 
      and sharing HLA-DR antigens on the outcome after pediatric liver transplantation. 
      Outcome parameters were graft survival, acute rejection, and portal fibrosis. A 
      distinction was made between full-size (FSLTx) and technical-variant liver 
      transplantation (TVLTx). A total of 136 primary transplants were analyzed. The 
      effect of HLA on the outcome parameters was analyzed by adjusted multivariate 
      logistic and Cox regression analysis. HLA mismatches, shared CREGs, and shared 
      HLA-DR antigens affected neither overall graft survival nor survival after FSLTx. 
      Survival after TVLTx was superior in case of 2 mismatches at the HLA-DR locus 
      compared to 0 or 1 mismatch (P = 0.01) and in case of no shared HLA-DR antigen 
      compared to 1 shared HLA-DR antigen (P = 0.004). The incidence of acute rejection 
      was not influenced by HLA. The incidence of portal fibrosis could be analyzed in 
      62 1-yr biopsies and was higher after TVLTx than FSLTx (P = 0.04). The incidence 
      of portal fibrosis after TVLTx with 0 or 1 mismatch at the HLA-DR locus was 100% 
      compared to 43% with 2 mismatches (P = 0.004). After multivariate analysis, 
      matching for HLA-DR and matching for TVLTx were independent risk factors for 
      portal fibrosis. In conclusion, an overall beneficial effect of HLA matching, 
      sharing CREGs, or sharing HLA-DR antigens was not observed. A negative effect was 
      present for HLA-DR matching and sharing HLA-DR antigens on survival after TVLTx. 
      HLA-DR matching might be associated with portal fibrosis in these grafts.
FAU - Sieders, Egbert
AU  - Sieders E
AD  - Department of Surgery, Division of Hepatobiliary Surgery and Liver 
      Transplantation, Liver Transplant Group, University Hospital Groningen, PO Box 
      30.001, 9700 RB Groningen, The Netherlands.
FAU - Hepkema, Bouke G
AU  - Hepkema BG
FAU - Peeters, Paul M J G
AU  - Peeters PM
FAU - TenVergert, Elisabeth M
AU  - TenVergert EM
FAU - de Jong, Koert P
AU  - de Jong KP
FAU - Porte, Robert J
AU  - Porte RJ
FAU - Bijleveld, Charles M A
AU  - Bijleveld CM
FAU - van den Berg, Aad P
AU  - van den Berg AP
FAU - Lems, Simon P M
AU  - Lems SP
FAU - Gouw, Annette S H
AU  - Gouw AS
FAU - Slooff, Maarten J H
AU  - Slooff MJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Liver Transpl
JT  - Liver transplantation : official publication of the American Association for the 
      Study of Liver Diseases and the International Liver Transplantation Society
JID - 100909185
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
SB  - IM
MH  - Adolescent
MH  - Biopsy
MH  - Child
MH  - Child, Preschool
MH  - Cross Reactions/immunology
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/epidemiology/immunology/pathology
MH  - Graft Survival
MH  - HLA-DR Antigens/*immunology
MH  - Histocompatibility Antigens Class I/*immunology
MH  - Histocompatibility Testing/*methods
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Infant, Newborn
MH  - Liver Cirrhosis/epidemiology/immunology/pathology
MH  - Liver Transplantation/*immunology
MH  - Male
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2005/11/30 09:00
MHDA- 2006/03/15 09:00
CRDT- 2005/11/30 09:00
PHST- 2005/11/30 09:00 [pubmed]
PHST- 2006/03/15 09:00 [medline]
PHST- 2005/11/30 09:00 [entrez]
AID - 10.1002/lt.20521 [doi]
PST - ppublish
SO  - Liver Transpl. 2005 Dec;11(12):1541-9. doi: 10.1002/lt.20521.