PMID- 28345271
OWN - NLM
STAT- MEDLINE
DCOM- 20180328
LR  - 20211204
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 31
IP  - 6
DP  - 2017 Jun
TI  - Immunosuppression with mTOR inhibitors prevents the development of donor-specific 
      antibodies after liver transplant.
LID - 10.1111/ctr.12974 [doi]
AB  - BACKGROUND: Donor-specific antibodies (DSAs) are an important cause of 
      complications after solid organ transplant. Risk factors and, thus, strategies 
      for preventing DSA development are not well defined. METHODS: The DSA status of 
      400 patients who underwent liver transplant (LT) at the outpatient clinic of the 
      University Hospital Essen was determined. Human leukocyte antigen (HLA) 
      antibodies were detected by single-antigen bead technology. The strength of DSAs 
      was reported as mean fluorescence intensity. RESULTS: Detectable DSAs were found 
      in 74 (18.5%) patients and significantly more often in patients who underwent LT 
      for autoimmune liver disease than for all other indications (29.3%; P=.022), but 
      significantly less often found in patients who underwent LT for hepatocellular 
      carcinoma (7.6%, P=.005). The incidence of DSAs increased with time after LT, and 
      the risk was generally higher for female patients. The frequency of DSA detection 
      was significantly lower (10.6%) for patients receiving immunosuppressive 
      treatment with mammalian target of rapamycin (mTOR) inhibitors than for those 
      receiving other regimens (20.5%; P=.025). CONCLUSION: Autoimmune liver diseases, 
      female sex, and time of more than 8 years since LT predispose patients to the 
      development of DSAs. Immunosuppression with the mTOR inhibitor everolimus 
      protects against DSA development after liver transplant.
CI  - (c) 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Willuweit, Katharina
AU  - Willuweit K
AD  - Department of Gastroenterology and Hepatology, University Hospital Essen, 
      University of Duisburg-Essen, Duisburg, Germany.
AD  - Department of General, Visceral and Transplantation Surgery, University Hospital 
      Essen, University of Duisburg-Essen, Duisburg, Germany.
FAU - Heinold, Andreas
AU  - Heinold A
AD  - Institute for Transfusion Medicine, University Hospital Essen, University of 
      Duisburg-Essen, Duisburg, Germany.
FAU - Rashidi-Alavijeh, Jassin
AU  - Rashidi-Alavijeh J
AD  - Department of Gastroenterology and Hepatology, University Hospital Essen, 
      University of Duisburg-Essen, Duisburg, Germany.
AD  - Department of General, Visceral and Transplantation Surgery, University Hospital 
      Essen, University of Duisburg-Essen, Duisburg, Germany.
FAU - Heinemann, Falko M
AU  - Heinemann FM
AD  - Institute for Transfusion Medicine, University Hospital Essen, University of 
      Duisburg-Essen, Duisburg, Germany.
FAU - Horn, Peter A
AU  - Horn PA
AD  - Institute for Transfusion Medicine, University Hospital Essen, University of 
      Duisburg-Essen, Duisburg, Germany.
FAU - Paul, Andreas
AU  - Paul A
AD  - Department of General, Visceral and Transplantation Surgery, University Hospital 
      Essen, University of Duisburg-Essen, Duisburg, Germany.
FAU - Gerken, Guido
AU  - Gerken G
AD  - Department of Gastroenterology and Hepatology, University Hospital Essen, 
      University of Duisburg-Essen, Duisburg, Germany.
FAU - Herzer, Kerstin
AU  - Herzer K
AUID- ORCID: 0000-0002-7270-2250
AD  - Department of Gastroenterology and Hepatology, University Hospital Essen, 
      University of Duisburg-Essen, Duisburg, Germany.
AD  - Department of General, Visceral and Transplantation Surgery, University Hospital 
      Essen, University of Duisburg-Essen, Duisburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20170416
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/blood/*drug therapy/etiology
MH  - Graft Survival
MH  - Humans
MH  - Immunosuppressive Agents/*pharmacology
MH  - Isoantibodies/*blood
MH  - Liver Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
MH  - *Tissue Donors
OTO - NOTNLM
OT  - donor-specific antibodies
OT  - everolimus
OT  - hepatocellular carcinoma
OT  - human leukocyte antigen antibodies
OT  - liver transplantation
EDAT- 2017/03/28 06:00
MHDA- 2018/03/29 06:00
CRDT- 2017/03/28 06:00
PHST- 2017/03/20 00:00 [accepted]
PHST- 2017/03/28 06:00 [pubmed]
PHST- 2018/03/29 06:00 [medline]
PHST- 2017/03/28 06:00 [entrez]
AID - 10.1111/ctr.12974 [doi]
PST - ppublish
SO  - Clin Transplant. 2017 Jun;31(6). doi: 10.1111/ctr.12974. Epub 2017 Apr 16.