PMID- 33949011
OWN - NLM
STAT- MEDLINE
DCOM- 20210722
LR  - 20210722
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 35
IP  - 7
DP  - 2021 Jul
TI  - Presence of donor specific HLA class 2 antibodies (DSA class 2) is associated 
      with development of graft fibrosis more than 10 years after liver 
      transplantation-a retrospective single center study.
PG  - e14336
LID - 10.1111/ctr.14336 [doi]
AB  - Here the impact of donor specific human leukocyte antigen (HLA) class 2 
      antibodies (DSA cl 2) on long term outcome after liver transplantation (LT) was 
      investigated. Altogether 156 (44 pediatric and 112 adult) LT recipients were 
      included in the study. Graft fibrosis was assessed by liver elastography and 
      biopsy. DSA cl 2 were determined by Luminex technology. 46% of LT recipients were 
      positive for DSA cl 2 after a median follow-up of 15 years. In the multivariate 
      analysis DSA cl 2 were significantly associated with immunosuppressive 
      monotherapy (OR 5.42; 95% CI: 1.02-28.90; p = .048). Compared to DSA cl 2 
      negative patients, positive recipients had significantly more graft fibrosis 
      based on the liver stiffness (mean 9.4 +/- 9.0 kPa vs. 6.5 +/- 6.3 kPa; p < .002) and 
      fibrosis stages determined by liver elastography (p = .016) and the performed 
      liver biopsies (p = .002). Also, a significantly higher incidence of chronic 
      rejections (11% vs. 2%; p = .045) and graft losses (6% vs. 0%; p = .043) were 
      found. In the multivariate regression analysis DSA cl 2 were significantly 
      associated with graft fibrosis (OR 4.57; 95% CI 1.59-13.10; p = .005). So, these 
      data suggest that development of DSA cl 2 occurs more often with 
      immunosuppressive monotherapy and may ultimately result in chronic rejection and 
      graft fibrosis.
CI  - (c) 2021 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.
FAU - Sultani, Bejan
AU  - Sultani B
AD  - Department of Medicine, University Medical Center Hamburg Eppendorf, Hamburg, 
      Germany.
FAU - Marget, Matthias
AU  - Marget M
AD  - Institute of Transfusion Medicine, University Medical Center Hamburg Eppendorf, 
      Hamburg, Germany.
FAU - Briem-Richter, Andrea
AU  - Briem-Richter A
AD  - Department of Pediatric Medicine, University Medical Center Hamburg Eppendorf, 
      Hamburg, Germany.
FAU - Herrmann, Jochen
AU  - Herrmann J
AD  - Department of Pediatric Radiology, University Medical Center Hamburg Eppendorf, 
      Hamburg, Germany.
FAU - Meisner, Sebastian
AU  - Meisner S
AD  - Department of Medicine, University Medical Center Hamburg Eppendorf, Hamburg, 
      Germany.
FAU - Grabhorn, Enke Freya
AU  - Grabhorn EF
AD  - Department of Pediatric Medicine, University Medical Center Hamburg Eppendorf, 
      Hamburg, Germany.
FAU - Ozga, Ann-Kathrin
AU  - Ozga AK
AD  - Insitute of Medical Biometry, University Medical Center Hamburg Eppendorf, 
      Hamburg, Germany.
FAU - Weidemann, Soren
AU  - Weidemann S
AD  - Department of Pathology, University Medical Center Hamburg Eppendorf, Hamburg, 
      Germany.
FAU - Herden, Uta
AU  - Herden U
AD  - Department of Visceral Transplantation, University Medical Center Hamburg 
      Eppendorf, Hamburg, Germany.
FAU - Fischer, Lutz
AU  - Fischer L
AD  - Department of Visceral Transplantation, University Medical Center Hamburg 
      Eppendorf, Hamburg, Germany.
FAU - Sterneck, Martina
AU  - Sterneck M
AUID- ORCID: 0000-0002-1593-2746
AD  - Department of Medicine, University Medical Center Hamburg Eppendorf, Hamburg, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210518
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Child
MH  - Fibrosis
MH  - Graft Rejection/etiology
MH  - Graft Survival
MH  - HLA Antigens
MH  - Histocompatibility Testing
MH  - Humans
MH  - Isoantibodies
MH  - *Liver Transplantation/adverse effects
MH  - Retrospective Studies
OTO - NOTNLM
OT  - fibrosis
OT  - liver disease: immune/inflammatory
OT  - rejection: antibodymediated (ABM)
EDAT- 2021/05/06 06:00
MHDA- 2021/07/23 06:00
CRDT- 2021/05/05 06:44
PHST- 2021/04/13 00:00 [revised]
PHST- 2020/08/29 00:00 [received]
PHST- 2021/04/26 00:00 [accepted]
PHST- 2021/05/06 06:00 [pubmed]
PHST- 2021/07/23 06:00 [medline]
PHST- 2021/05/05 06:44 [entrez]
AID - 10.1111/ctr.14336 [doi]
PST - ppublish
SO  - Clin Transplant. 2021 Jul;35(7):e14336. doi: 10.1111/ctr.14336. Epub 2021 May 18.