PMID- 38010995
OWN - NLM
STAT- MEDLINE
DCOM- 20240131
LR  - 20240131
IS  - 1478-3231 (Electronic)
IS  - 1478-3223 (Linking)
VI  - 44
IP  - 2
DP  - 2024 Feb
TI  - HLA matching between donors and recipients improves clinical liver transplant 
      graft survival.
PG  - 411-421
LID - 10.1111/liv.15774 [doi]
AB  - BACKGROUND AND AIMS: The importance of human leukocyte antigen (HLA) matching 
      between liver transplant donors and recipients on graft survival remains unclear 
      and is not a clinical consideration in liver transplantation. This study aimed to 
      determine the relationship between HLA matching and liver graft survival using a 
      large-scale multi-centre database (UNOS/OPTN) and multivariate logistic analysis. 
      The secondary aim was to determine whether this relationship was influenced by 
      transplant indication and donor status. METHODS: This retrospective observational 
      analysis was performed using 22 702 liver transplant recipients from the 
      UNOS/OPTN database. Patients were divided into two groups based on number of HLA 
      mismatches (0-3 mismatches vs. 4-6 mismatches) and then subcategorized by 
      indication and donor status. Risk-adjusted outcomes were assessed by multivariate 
      Cox analysis adjusting for donor and recipient characteristics and visualized 
      using Kaplan-Meier survival curves. RESULTS: Allograft survival and risk of acute 
      rejection were associated with degree of HLA mismatch. This association between 
      HLA mismatch and graft survival persisted in individuals who underwent transplant 
      for hepatitis, metabolic, drug toxicity, and congenital indications. Donor status 
      also influenced the relationship between HLA mismatch and graft survival. Graft 
      survival in DBD recipients was longer than in DCD in the 4-6 HLA mismatch group, 
      whereas no significant difference was found in the 0-3 HLA mismatch group. 
      CONCLUSION: HLA mismatch significantly reduced graft survival and increased risk 
      of acute rejection. This association was noted only in specific indications. 
      These findings are of potential clinical relevance to organ allocation, allograft 
      matching algorithms, immunosuppression protocols, and transplant surveillance.
CI  - (c) 2023 The Authors. Liver International published by John Wiley & Sons Ltd.
FAU - Nabulsi, Sarah
AU  - Nabulsi S
AD  - Department of Life Sciences, Imperial College London, London, UK.
FAU - Otunla, Afolarin A
AU  - Otunla AA
AUID- ORCID: 0000-0002-9091-7853
AD  - North Middlesex University Hospitals, London, UK.
FAU - Salciccioli, Justin
AU  - Salciccioli J
AD  - Department of Critical Care, Brigham and Women's Hospital, Boston, Massachusetts, 
      USA.
FAU - Marshall, Dominic C
AU  - Marshall DC
AD  - Department of Surgery & Cancer, Imperial College London, London, UK.
FAU - Villani, Vincenzo
AU  - Villani V
AD  - Department of Transplantation, Memorial Hermann Health System, Houston, Texas, 
      USA.
FAU - Shanmugarajah, Kumaran
AU  - Shanmugarajah K
AD  - Department of Surgery, University of Chicago, Chicago, Illinois, USA.
FAU - Shalhoub, Joseph
AU  - Shalhoub J
AD  - Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial 
      College London, London, UK.
AD  - Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20231127
PL  - United States
TA  - Liver Int
JT  - Liver international : official journal of the International Association for the 
      Study of the Liver
JID - 101160857
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Humans
MH  - *Graft Survival
MH  - *Liver Transplantation
MH  - Retrospective Studies
MH  - Graft Rejection/epidemiology
MH  - Histocompatibility Testing
MH  - Tissue Donors
MH  - HLA Antigens
OTO - NOTNLM
OT  - acute rejection
OT  - graft survival
OT  - hla matching
OT  - indications
OT  - liver
EDAT- 2023/11/27 18:43
MHDA- 2024/01/31 06:42
CRDT- 2023/11/27 12:53
PHST- 2023/10/03 00:00 [revised]
PHST- 2023/07/06 00:00 [received]
PHST- 2023/10/16 00:00 [accepted]
PHST- 2024/01/31 06:42 [medline]
PHST- 2023/11/27 18:43 [pubmed]
PHST- 2023/11/27 12:53 [entrez]
AID - 10.1111/liv.15774 [doi]
PST - ppublish
SO  - Liver Int. 2024 Feb;44(2):411-421. doi: 10.1111/liv.15774. Epub 2023 Nov 27.