PMID- 18383092
OWN - NLM
STAT- MEDLINE
DCOM- 20080806
LR  - 20080403
IS  - 1527-6473 (Electronic)
IS  - 1527-6465 (Linking)
VI  - 14
IP  - 4
DP  - 2008 Apr
TI  - Preformed antibodies detected by cytotoxic assay or multibead array decrease 
      liver allograft survival: role of human leukocyte antigen compatibility.
PG  - 554-62
LID - 10.1002/lt.21408 [doi]
AB  - 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 = 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 (Luminex xMAP) showed a strong correlation 
      between both techniques (P < 0.0001). Both CDC-detected and Luminex-detected 
      antibodies were associated with shorter graft survival within the first year 
      post-transplant (P = 0.01 and P = 0.016, respectively). Positive CDC T 
      crossmatches and Luminex-detected HLA class II antibodies played a significant 
      role in decreasing graft survival (P = 0.043 and P = 0.0019 at 1 year, 
      respectively, and P = 0.005 and P = 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 = 0.001 and P 
      = 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.
CI  - (c) 2008 AASLD.
FAU - Castillo-Rama, Marcela
AU  - Castillo-Rama M
AD  - Department of Immunology, Hospital Doce de Octubre, Madrid, Spain. 
      mcastillo.hdoc@salud.madrid.org
FAU - Castro, Maria Jose
AU  - Castro MJ
FAU - Bernardo, Ivan
AU  - Bernardo I
FAU - Meneu-Diaz, Juan Carlos
AU  - Meneu-Diaz JC
FAU - Elola-Olaso, Almudena Moreno
AU  - Elola-Olaso AM
FAU - Calleja-Antolin, Sara M
AU  - Calleja-Antolin SM
FAU - Romo, Eva
AU  - Romo E
FAU - Morales, Pablo
AU  - Morales P
FAU - Moreno, Enrique
AU  - Moreno E
FAU - Paz-Artal, Estela
AU  - Paz-Artal E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
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 Antigens)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Blood Group Incompatibility/*immunology
MH  - Child
MH  - Cohort Studies
MH  - *Cytotoxicity, Immunologic
MH  - Graft Rejection/immunology
MH  - Graft Survival/*immunology
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Liver Failure/immunology/surgery
MH  - Liver Transplantation/*immunology
MH  - Retrospective Studies
MH  - Transplantation, Homologous/immunology
EDAT- 2008/04/03 09:00
MHDA- 2008/08/07 09:00
CRDT- 2008/04/03 09:00
PHST- 2008/04/03 09:00 [pubmed]
PHST- 2008/08/07 09:00 [medline]
PHST- 2008/04/03 09:00 [entrez]
AID - 10.1002/lt.21408 [doi]
PST - ppublish
SO  - Liver Transpl. 2008 Apr;14(4):554-62. doi: 10.1002/lt.21408.