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Risk factors for acute rejection in pediatric living related liver transplantation: The impact of HLA matching
Author(s) -
Sugawara Yasuhiko,
Mizuta Koichi,
Kawarasaki Hideo,
Takayama Tadatoshi,
Imamura Hiroshi,
Makuuchi Masatoshi
Publication year - 2001
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2001.27089
Subject(s) - medicine , liver transplantation , ascites , incidence (geometry) , cadaveric spasm , surgery , transplantation , gastroenterology , prothrombin time , human leukocyte antigen , immunology , antigen , physics , optics
The influence of HLA compatibility on acute rejection in cadaveric liver transplantation is not clearly defined, and that in living related liver transplantation (LRLT) has only been poorly examined. Few studies have focused solely on a pediatric population. Fifty‐eight cases of pediatric LRLT were analyzed. Patient and graft survival rates and postoperative complications were assessed. The relationship between the incidence of acute rejection and HLA matching and some preoperative and intraoperative transplant recipient factors, including age, preoperative aspartate aminotransferase level, total bilirubin level, prothrombin time, ascites, donor‐recipient blood group type and sex match, donor age, surgical time, anhepatic phase duration, volume of blood loss, and graft weight to standard liver volume, was examined. Patients with HLA‐A zero mismatching ( P = .04) or a greater volume of blood loss per body weight ( P = .004) had a significantly lower chance of rejection within 6 weeks after LRLT. Our results show that in LRLT, a graft from an HLA‐A zero‐mismatched donor may be advantageous because it provides a lower chance of early acute rejection.