PMID- 35152544 OWN - NLM STAT- MEDLINE DCOM- 20220718 LR - 20230509 IS - 1527-6473 (Electronic) IS - 1527-6465 (Print) IS - 1527-6465 (Linking) VI - 28 IP - 8 DP - 2022 Aug TI - Assessment of human leukocyte antigen matching algorithm PIRCHE-II on liver transplantation outcomes. PG - 1356-1366 LID - 10.1002/lt.26431 [doi] AB - For liver transplantations, human leukocyte antigen (HLA) matching is not routinely performed because observed effects have been inconsistent. Nevertheless, long-term liver transplantation outcomes remain suboptimal. The availability of a more precise HLA-matching algorithm, Predicted Indirectly Recognizable HLA Epitopes II (PIRCHE-II), now enables robust assessment of the association between HLA matching and liver transplantation outcomes. We performed a single-center retrospective cohort study of 736 liver transplantation patients. Associations between PIRCHE-II and HLAMatchmaker scores and mortality, graft loss, acute and chronic rejection, ischemic cholangiopathy, and disease recurrence were evaluated with Cox proportional hazards models. Associations between PIRCHE-II with 1-year, 2-year, and 5-year outcomes and severity of acute rejection were assessed with logistic and linear regression analyses, respectively. Subgroup analyses were performed for autoimmune and nonautoimmune indications, and patients aged 30 years and younger, and older than 30 years. PIRCHE-II and HLAMatchmaker scores were not associated with any of the outcomes. However, patients who received transplants for autoimmune disease showed more acute rejection and graft loss, and these risks negatively associated with age. Rhesus mismatch more than doubled the risk of disease recurrence. Moreover, PIRCHE-II was inversely associated with graft loss in the subgroup of patients aged 30 years and younger with autoimmune indications. The absence of associations between PIRCHE-II and HLAMatchmaker scores and the studied outcomes refutes the need for HLA matching for liver (stem cell) transplantations for nonautoimmune disease. For autoimmune disease, the activated immune system seems to increase risks of acute rejection and graft loss. Our results may suggest the benefits of transplantations with rhesus matched but PIRCHE-II mismatched donor livers. CI - (c) 2022 The Authors. Liver Transplantation published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. FAU - Kok, Gautam AU - Kok G AUID- ORCID: 0000-0002-4285-3381 AD - Department of Metabolic DiseasesWilhelmina Children's Hospital, University Medical Center UtrechtUtrechtThe Netherlands. FAU - Verstegen, Monique M A AU - Verstegen MMA AUID- ORCID: 0000-0001-9908-6673 AD - Department of SurgeryDivision of Hepatopancreatobiliary and Transplant SurgeryErasmus Medical Center Transplant Institute, University Medical Center RotterdamRotterdamThe Netherlands. FAU - Houwen, Roderick H J AU - Houwen RHJ AD - Department of Pediatric GastroenterologyWilhelmina Children's Hospital, University Medical Center UtrechtUtrechtThe Netherlands. FAU - Nieuwenhuis, Edward E S AU - Nieuwenhuis EES AD - Department of Pediatric GastroenterologyWilhelmina Children's Hospital, University Medical Center UtrechtUtrechtThe Netherlands. FAU - Metselaar, Herold J AU - Metselaar HJ AD - Department of Gastroenterology & HepatologyErasmus Medical Center Transplant InstituteUniversity Medical Center RotterdamRotterdamThe Netherlands. FAU - Polak, Wojciech G AU - Polak WG AD - Department of SurgeryDivision of Hepatopancreatobiliary and Transplant SurgeryErasmus Medical Center Transplant Institute, University Medical Center RotterdamRotterdamThe Netherlands. FAU - van der Laan, Luc J W AU - van der Laan LJW AUID- ORCID: 0000-0002-0651-5334 AD - Department of SurgeryDivision of Hepatopancreatobiliary and Transplant SurgeryErasmus Medical Center Transplant Institute, University Medical Center RotterdamRotterdamThe Netherlands. FAU - Spierings, Eric AU - Spierings E AD - Center of Translational ImmunologyUniversity Medical Center UtrechtUtrechtThe Netherlands. FAU - den Hoed, Caroline M AU - den Hoed CM AD - Department of Gastroenterology & HepatologyErasmus Medical Center Transplant InstituteUniversity Medical Center RotterdamRotterdamThe Netherlands. FAU - Fuchs, Sabine A AU - Fuchs SA AD - Department of Metabolic DiseasesWilhelmina Children's Hospital, University Medical Center UtrechtUtrechtThe Netherlands. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220425 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) SB - IM MH - Algorithms MH - *Autoimmune Diseases MH - Graft Rejection/epidemiology MH - Graft Survival MH - HLA Antigens MH - Histocompatibility Testing MH - Humans MH - *Liver Transplantation/adverse effects MH - Retrospective Studies PMC - PMC9544750 COIS- The University Medical Center Utrecht has filed a patent application on the prediction of an alloimmune response against mismatched human leukocyte antigen. Dr. Spierings is listed as inventor on this patent. The other authors declare to have no conflicts of interest. EDAT- 2022/02/14 06:00 MHDA- 2022/07/19 06:00 PMCR- 2022/10/07 CRDT- 2022/02/13 20:38 PHST- 2022/01/25 00:00 [revised] PHST- 2021/12/09 00:00 [received] PHST- 2022/01/31 00:00 [accepted] PHST- 2022/02/14 06:00 [pubmed] PHST- 2022/07/19 06:00 [medline] PHST- 2022/02/13 20:38 [entrez] PHST- 2022/10/07 00:00 [pmc-release] AID - 01445473-202208000-00013 [pii] AID - LT26431 [pii] AID - 10.1002/lt.26431 [doi] PST - ppublish SO - Liver Transpl. 2022 Aug;28(8):1356-1366. doi: 10.1002/lt.26431. Epub 2022 Apr 25.