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Impact of HLA‐compatibilities in patients undergoing liver transplantation for HBV‐cirrhosis
Author(s) -
Neumann Ulf P,
Langrehr Jan M,
Naumann Uta,
Lang Martina,
Rayes Nada,
Steinmüller Thomas,
Radtke Cornelia,
Neuhaus Peter
Publication year - 2002
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2002.1o008.x
Subject(s) - medicine , liver transplantation , human leukocyte antigen , cirrhosis , immunosuppression , hepatitis b virus , hepatitis b , gastroenterology , retrospective cohort study , transplantation , stage (stratigraphy) , tacrolimus , immunology , antigen , virus , paleontology , biology
Liver transplantation (OLT) for end‐stage chronic hepatitis‐B‐virus (HBV) infection is frequently complicated by HBV recurrence. In the present study we investigated whether human leucocyte antigen (HLA)‐matching influences the outcome after OLT. In a retrospective analysis we reviewed 84 recipients of liver transplants for end‐stage HBV‐cirrhosis and complete HLA‐typing for outcome after OLT. Follow‐up ranges from 1 to 110 months (median=55.6 months). Immunosuppression consisted of Cyclosporin A (CsA)‐based quadruple induction therapy or Tacrolimus‐based induction protocols. Immunoprophylaxis with hepatitis B immunoglobulin was started at OLT and continued long‐term. Actuarial 1‐ and 5‐yr graft survival figures were 90.5 and 80.4%, respectively. Hepatitis‐B recurrence was responsible for 15 of 20 (75%) graft failures. We observed a significantly improved graft survival in patients with more HLA‐A, ‐B compatibilities (p=0.02), whereas the degree of HLA‐DR compatibilities did not influence the outcome. The occurrence of HBV‐reinfection was significantly lower in HLA‐A, ‐B matched grafts (p < 0.05). Additionally, graft survival was prolonged in patients with HBV‐reinfection and 1 or 2 HLA‐B compatibilities when compared with patients with HBV‐reinfection and a complete HLA‐B mismatch (p=0.02). In conclusion, this retrospective analysis shows that more HLA‐A, ‐B compatibilities seems to be associated with an improved graft survival in patients after OLT for end‐stage HBV infection.