PMID- 24714061
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211021
IS  - 1108-7471 (Print)
IS  - 1792-7463 (Electronic)
IS  - 1108-7471 (Linking)
VI  - 25
IP  - 1
DP  - 2012
TI  - Antibody-mediated rejection after adult living-donor liver transplantation 
      triggered by positive lymphocyte cross-match combination.
PG  - 66-72
AB  - A 46-year-old female suffering from liver cirrhosis was referred to us for 
      living-donor liver transplantation (LDLT). Pre-transplant lymphocyte cross-match 
      tests were positive. The recipient showed immunoreactivity against donor human 
      leukocyte antigen (HLA) Class I antigens, a finding confirmed by flow cytometry. 
      Additional tests confirmed donor-specific lymphocyte immunoreactivity against HLA 
      B 55. As no other suitable donor was available, we performed LDLT coupled with 
      splenectomy, despite the positive cross-match. Tacrolimus, methylprednisolone and 
      mycophenolate mofetil were used postoperatively for immunosuppression. The 
      postoperative course was uneventful until Day 3 when blood tests showed disorders 
      in liver function and the patient's condition suddenly worsened. Although 
      intensive care (including plasma exchange) was given, her condition continued to 
      deteriorate. Flow cytometry initially showed that immunoreactivity against Class 
      I antigens was down-regulated immediately after LDLT, but further testing showed 
      that it had increased again. We diagnosed humoral rejection based on clinical, 
      immunological and histopathological findings and suggest that this was mediated 
      by an immune response to donor-specific antigens. The patient experienced 
      multi-organ failure and died on post-operative Day 9.
FAU - Hori, Tomohide
AU  - Hori T
AD  - Divisions of Hepato-Biliary-Pancreatic, Transplant and Pediatric Surgery, 
      Department of Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto, 606-8507, 
      Japan.
FAU - Egawa, Hiroto
AU  - Egawa H
AD  - Divisions of Hepato-Biliary-Pancreatic, Transplant and Pediatric Surgery, 
      Department of Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto, 606-8507, 
      Japan.
FAU - Uemoto, Shinji
AU  - Uemoto S
AD  - Divisions of Hepato-Biliary-Pancreatic, Transplant and Pediatric Surgery, 
      Department of Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto, 606-8507, 
      Japan.
LA  - eng
PT  - Case Reports
PL  - Greece
TA  - Ann Gastroenterol
JT  - Annals of gastroenterology
JID - 101121847
PMC - PMC3959345
OTO - NOTNLM
OT  - antibody-mediated rejection
OT  - cross-match
OT  - human leukocyte antigen
OT  - humoral rejection
OT  - liver transplantation
COIS- Conflict of Interest: None
EDAT- 2012/01/01 00:00
MHDA- 2012/01/01 00:01
PMCR- 2012/01/01
CRDT- 2014/04/10 06:00
PHST- 2014/04/10 06:00 [entrez]
PHST- 2012/01/01 00:00 [pubmed]
PHST- 2012/01/01 00:01 [medline]
PHST- 2012/01/01 00:00 [pmc-release]
AID - AnnGastroenterol-25-66 [pii]
PST - ppublish
SO  - Ann Gastroenterol. 2012;25(1):66-72.