PMID- 35603526
OWN - NLM
STAT- MEDLINE
DCOM- 20220922
LR  - 20230509
IS  - 1527-6473 (Electronic)
IS  - 1527-6465 (Print)
IS  - 1527-6465 (Linking)
VI  - 28
IP  - 10
DP  - 2022 Oct
TI  - The impact of human leukocyte antigen mismatch on recipient outcomes in 
      living-donor liver transplantation.
PG  - 1588-1602
LID - 10.1002/lt.26511 [doi]
AB  - Donor-recipient human leukocyte antigen (HLA) compatibility has not been 
      considered to significantly affect liver transplantation (LT) outcomes; however, 
      its significance in living-donor LT (LDLT), which is mostly performed between 
      blood relatives, remains unclear. This retrospective cohort study included 1954 
      LDLTs at our institution (1990-2020). The primary and secondary endpoints were 
      recipient survival and the incidence of T cell-mediated rejection (TCMR) after 
      LDLT, respectively, according to the number of HLA mismatches at all five loci: 
      HLA-A, HLA-B, HLA-C, HLA-DR, and HLA-DQ. Subgroup analyses were also performed in 
      between-siblings that characteristically have widely distributed 0-10 HLA 
      mismatches. A total of 1304 cases of primary LDLTs were finally enrolled, 
      including 631 adults (recipient age at LT >/=18 years) and 673 children (<18 
      years). In adult-to-adult LDLT, the more HLA mismatches at each locus, the 
      significantly worse the recipient survival was (p = 0.03, 0.01, 0.03, 0.001, and 
      <0.001 for HLA-A, HLA-B, HLA-C, HLA-DR, and HLA-DQ, respectively). This trend was 
      more pronounced when multiple loci were combined (all p < 0.001 for A + B + DR, 
      A + B + C, DR + DQ, and A + B + C + DR + DQ). Notably, a total of three or more 
      HLA-B + DR mismatches was an independent risk factor for both TCMR (hazard ratio 
      [HR] 2.66, 95% confidence interval [CI] 1.21-5.87; p = 0.02) and recipient 
      survival (HR 2.44, 95% CI 1.11-5.35; p = 0.03) in between-siblings. By contrast, 
      HLA mismatch did not affect pediatric LDLT outcomes at any locus or in any 
      combinations; however, it should be noted that all donor-recipient relationships 
      are parent-to-child that characteristically possesses one or less HLA mismatch at 
      each locus and maximally five or less mismatches in total. In conclusion, HLA 
      mismatch significantly affects not only TCMR development but also recipient 
      survival in adult LDLT, but not in children.
CI  - (c) 2022 The Authors. Liver Transplantation published by Wiley Periodicals LLC on 
      behalf of American Association for the Study of Liver Diseases.
FAU - Tajima, Tetsuya
AU  - Tajima T
AD  - Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of 
      Surgery, Graduate School of Medicine Kyoto University Kyoto Japan Department of 
      Clinical Laboratory Medicine Kyoto University Hospital Kyoto Japan Department of 
      Pediatric Surgery Kanazawa Medical University Kanazawa Japan Department of 
      Diagnostic Pathology Kyoto University Hospital Kyoto Japan Shiga University of 
      Medical Science Japan.
FAU - Hata, Koichiro
AU  - Hata K
FAU - Kusakabe, Jiro
AU  - Kusakabe J
FAU - Miyauchi, Hidetaka
AU  - Miyauchi H
FAU - Yurugi, Kimiko
AU  - Yurugi K
FAU - Hishida, Rie
AU  - Hishida R
FAU - Ogawa, Eri
AU  - Ogawa E
FAU - Okamoto, Tatsuya
AU  - Okamoto T
FAU - Sonoda, Mari
AU  - Sonoda M
FAU - Kageyama, Shoichi
AU  - Kageyama S
FAU - Zhao, Xiangdong
AU  - Zhao X
FAU - Ito, Takashi
AU  - Ito T
FAU - Seo, Satoru
AU  - Seo S
FAU - Okajima, Hideaki
AU  - Okajima H
FAU - Nagao, Miki
AU  - Nagao M
FAU - Haga, Hironori
AU  - Haga H
FAU - Uemoto, Shinji
AU  - Uemoto S
FAU - Hatano, Etsuro
AU  - Hatano E
LA  - eng
PT  - Journal Article
DEP - 20220704
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)
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-C Antigens)
RN  - 0 (HLA-DQ Antigens)
RN  - 0 (HLA-DR Antigens)
SB  - IM
MH  - Adult
MH  - Child
MH  - Graft Rejection/epidemiology
MH  - Graft Survival
MH  - HLA Antigens
MH  - HLA-A Antigens
MH  - HLA-B Antigens
MH  - HLA-C Antigens
MH  - HLA-DQ Antigens
MH  - HLA-DR Antigens
MH  - Histocompatibility Testing
MH  - Humans
MH  - *Liver Transplantation/adverse effects
MH  - *Living Donors
MH  - Retrospective Studies
PMC - PMC9796617
COIS- Nothing to report.
EDAT- 2022/05/24 06:00
MHDA- 2022/09/23 06:00
PMCR- 2022/12/28
CRDT- 2022/05/23 05:25
PHST- 2022/04/19 00:00 [revised]
PHST- 2022/02/24 00:00 [received]
PHST- 2022/05/10 00:00 [accepted]
PHST- 2022/05/24 06:00 [pubmed]
PHST- 2022/09/23 06:00 [medline]
PHST- 2022/05/23 05:25 [entrez]
PHST- 2022/12/28 00:00 [pmc-release]
AID - 01445473-202210000-00008 [pii]
AID - LT26511 [pii]
AID - 10.1002/lt.26511 [doi]
PST - ppublish
SO  - Liver Transpl. 2022 Oct;28(10):1588-1602. doi: 10.1002/lt.26511. Epub 2022 Jul 4.