PMID- 30112820
OWN - NLM
STAT- MEDLINE
DCOM- 20190716
LR  - 20190716
IS  - 1527-6473 (Electronic)
IS  - 1527-6465 (Linking)
VI  - 24
IP  - 12
DP  - 2018 Dec
TI  - Donor-Specific Antibodies in Pediatric Intestinal and Multivisceral 
      Transplantation: The Role of Liver and Human Leukocyte Antigen Mismatching.
PG  - 1726-1735
LID - 10.1002/lt.25323 [doi]
AB  - Rejection is one of the most important drawbacks for graft and patient survival 
      in intestinal and multivisceral transplantation. However, there is no consensus 
      on the diagnostic criteria for humoral rejection, and the literature about the 
      role of donor-specific antibodies (DSA) on allograft outcome and the risk factors 
      that contribute to their development is scant with contradictory results. The 
      present study analyzes the role of DSA exclusively in a pediatric cohort of 43 
      transplants. Among our patients, 11.6% showed preformed DSA, but they did not 
      correlate with more rejection or less allograft survival. Having previous 
      transplants was the main sensitization factor with an odds ratio (OR) = 44.85 (P 
      = 0.001). In total, 16.3% of recipients developed de novo donor-specific 
      antibodies (dnDSA), mostly directed against human leukocyte antigen (HLA) class 
      II, polyspecific and complement fixing. Additionally, the presence of dnDSA had a 
      deleterious effect on graft rejection (hazard ratio [HR] = 11.00; P = 0.01) and 
      survival (HR = 66.52; P < 0.001) in an observational period of 5 years after 
      transplantation. The inclusion of the liver emerged as the main protective factor 
      against dnDSA development with an OR = 0.07 (P = 0.007). The analysis of HLA 
      compatibility at the serological and epitope level with the computational tools 
      HLAMatchmaker and PIRCHE revealed no association between HLA mismatching and 
      dnDSA. In conclusion, this study performed in pediatric recipients shows the 
      deleterious effect of dnDSA on intestinal transplantation supported by the 
      complement-fixing activity observed. Additionally, the liver inclusion in the 
      allografts showed to be a protective factor against dnDSA generation.
CI  - Copyright (c) 2018 by the American Association for the Study of Liver Diseases.
FAU - Talayero, Paloma
AU  - Talayero P
AD  - Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain.
AD  - I+12 Research Institute, University Hospital 12 de Octubre, Madrid, Spain.
FAU - Ramos Boluda, Esther
AU  - Ramos Boluda E
AD  - Pediatric Gastroenterology Intestinal Rehabilitation Unit, University Hospital La 
      Paz, Madrid, Spain.
FAU - Gomez Massa, Elena
AU  - Gomez Massa E
AD  - Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain.
AD  - I+12 Research Institute, University Hospital 12 de Octubre, Madrid, Spain.
FAU - Castro Panete, Maria Jose
AU  - Castro Panete MJ
AD  - Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain.
FAU - Prieto Bozano, Gerardo
AU  - Prieto Bozano G
AD  - Pediatric Gastroenterology Intestinal Rehabilitation Unit, University Hospital La 
      Paz, Madrid, Spain.
FAU - Hernandez Oliveros, Francisco
AU  - Hernandez Oliveros F
AD  - Department of Pediatric Surgery, University Hospital La Paz, Madrid, Spain.
AD  - EOC of ERN-Transplantchild, University Hospital La Paz, Madrid, Spain.
FAU - Lopez Santamaria, Manuel
AU  - Lopez Santamaria M
AD  - Department of Pediatric Surgery, University Hospital La Paz, Madrid, Spain.
FAU - Calvo Pulido, Jorge
AU  - Calvo Pulido J
AD  - General and Digestive Surgery and Abdominal Organ Transplantation, University 
      Hospital 12 de Octubre, Madrid, Spain.
AD  - School of Medicine, Complutense University, Madrid, Spain.
FAU - Paz-Artal, Estela
AU  - Paz-Artal E
AD  - Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain.
AD  - I+12 Research Institute, University Hospital 12 de Octubre, Madrid, Spain.
AD  - School of Medicine, Complutense University, Madrid, Spain.
AD  - Section of Immunology, San Pablo CEU University, Madrid, Spain.
FAU - Mancebo, Esther
AU  - Mancebo E
AD  - Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain.
AD  - I+12 Research Institute, University Hospital 12 de Octubre, Madrid, Spain.
AD  - School of Medicine, Complutense University, Madrid, Spain.
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-D Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
CIN - Liver Transpl. 2018 Dec;24(12):1651-1652. PMID: 30369014
MH  - Adolescent
MH  - Allografts/immunology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*immunology
MH  - Graft Survival/immunology
MH  - HLA-D Antigens/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunity, Humoral
MH  - Infant
MH  - Infant, Newborn
MH  - Intestines/*transplantation
MH  - Isoantibodies/*immunology
MH  - Liver/immunology
MH  - Liver Transplantation/*adverse effects/methods
MH  - Malabsorption Syndromes/*surgery
MH  - Male
MH  - Risk Factors
MH  - Transplantation, Homologous/adverse effects
MH  - Treatment Outcome
EDAT- 2018/08/17 06:00
MHDA- 2019/07/17 06:00
CRDT- 2018/08/17 06:00
PHST- 2018/04/09 00:00 [received]
PHST- 2018/08/07 00:00 [accepted]
PHST- 2018/08/17 06:00 [pubmed]
PHST- 2019/07/17 06:00 [medline]
PHST- 2018/08/17 06:00 [entrez]
AID - 10.1002/lt.25323 [doi]
PST - ppublish
SO  - Liver Transpl. 2018 Dec;24(12):1726-1735. doi: 10.1002/lt.25323.