PMID- 37746594
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231013
IS  - 2691-3593 (Electronic)
IS  - 2691-3593 (Linking)
VI  - 4
IP  - 3
DP  - 2023 Sep
TI  - The Effect of Genetic HLA Matching on Liver Transplantation Outcome: A Systematic 
      Review and Meta-Analysis.
PG  - e334
LID - 10.1097/AS9.0000000000000334 [doi]
AB  - OBJECTIVE: We aim to investigate the effects of genetically based HLA matching on 
      patient and graft survival, and acute and chronic rejection after liver 
      transplantation. BACKGROUND: Liver transplantation is a common treatment for 
      patients with end-stage liver disease. In contrast to most other solid organ 
      transplantations, there is no conclusive evidence supporting human leukocyte 
      antigen (HLA) matching for liver transplantations. With emerging alternatives 
      such as transplantation of bankable (stem) cells, HLA matching becomes feasible, 
      which may decrease the need for immunosuppressive therapy and improve 
      transplantation outcomes. METHODS: We systematically searched the PubMed, Embase, 
      and Cochrane databases and performed a meta-analysis investigating the effect of 
      genetic HLA matching on liver transplantation outcomes (acute/chronic rejection, 
      graft failure, and mortality). RESULTS: We included 14 studies with 2682 
      patients. HLA-C mismatching significantly increased the risk of acute rejection 
      (full mismatching: risk ratio = 1.90, 95% confidence interval = 1.08 to 3.33, P = 
      0.03; partial mismatching: risk ratio = 1.33, 95% confidence interval = 1.07 to 
      1.66, P = 0.01). We did not discern any significant effect of HLA mismatching per 
      locus on acute rejection for HLA-A, -B, -DR, and -DQ, nor on chronic rejection, 
      graft failure, or mortality for HLA-DR, and -DQ. CONCLUSIONS: We found evidence 
      that genetic HLA-C matching reduces the risk of acute rejection after liver 
      transplantation while matching for other loci does not reduce the risk of acute 
      rejection, chronic rejection, graft failure, or mortality.
CI  - Copyright (c) 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Kok, Gautam
AU  - Kok G
AD  - From the Department of Metabolic Diseases, Wilhelmina Children's Hospital, 
      Utrecht, The Netherlands.
FAU - Ilcken, Eveline F
AU  - Ilcken EF
AD  - From the Department of Metabolic Diseases, Wilhelmina Children's Hospital, 
      Utrecht, The Netherlands.
FAU - Houwen, Roderick H J
AU  - Houwen RHJ
AD  - Department of Pediatric Gastroenterology, Wilhelmina Children's Hospital, 
      Utrecht, The Netherlands.
FAU - Lindemans, Caroline A
AU  - Lindemans CA
AD  - Department of Immunology, Princess Maxima Center for Pediatric Oncology, Utrecht, 
      The Netherlands.
AD  - Department of Hematopoietic Cell Transplantation, Princess Maxima Center for 
      Pediatric Oncology, Utrecht, The Netherlands.
FAU - Nieuwenhuis, Edward E S
AU  - Nieuwenhuis EES
AD  - Department of Pediatric Gastroenterology, Wilhelmina Children's Hospital, 
      Utrecht, The Netherlands.
FAU - Spierings, Eric
AU  - Spierings E
AD  - Center of Translational Immunology, Utrecht University Medical Center, Utrecht, 
      The Netherlands.
FAU - Fuchs, Sabine A
AU  - Fuchs SA
AD  - From the Department of Metabolic Diseases, Wilhelmina Children's Hospital, 
      Utrecht, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20230915
PL  - United States
TA  - Ann Surg Open
JT  - Annals of surgery open : perspectives of surgical history, education, and 
      clinical approaches
JID - 101769928
PMC - PMC10513352
OTO - NOTNLM
OT  - HLA
OT  - HLA matching
OT  - acute rejection
OT  - human leukocyte antigen
OT  - liver transplantation
OT  - transplantation outcomes
COIS- Disclosure: The University Medical Center Utrecht has filed a patent application 
      on the prediction of an alloimmune response against mismatched human leukocyte 
      antigen. Eric Spierings is listed as inventor on this patent. The other authors 
      declare to have no conflicts of interest.
EDAT- 2023/09/25 06:42
MHDA- 2023/09/25 06:43
PMCR- 2023/09/15
CRDT- 2023/09/25 05:18
PHST- 2022/11/21 00:00 [received]
PHST- 2023/08/11 00:00 [accepted]
PHST- 2023/09/25 06:43 [medline]
PHST- 2023/09/25 06:42 [pubmed]
PHST- 2023/09/25 05:18 [entrez]
PHST- 2023/09/15 00:00 [pmc-release]
AID - 10.1097/AS9.0000000000000334 [doi]
PST - epublish
SO  - Ann Surg Open. 2023 Sep 15;4(3):e334. doi: 10.1097/AS9.0000000000000334. 
      eCollection 2023 Sep.