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Prevalence, Incidence and Risk Factors for Donor‐Specific Anti‐HLA Antibodies in Maintenance Liver Transplant Patients
Author(s) -
Del Bello A.,
CongyJolivet N.,
Muscari F.,
Lavayssière L.,
Esposito L.,
CardeauDesangles I.,
Guitard J.,
Dörr G.,
Suc B.,
Duffas J. P.,
Alric L.,
Bureau C.,
Danjoux M.,
GuilbeauFrugier C.,
Blancher A.,
Rostaing L.,
Kamar N.
Publication year - 2014
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.12651
Subject(s) - medicine , liver transplantation , donor specific antibodies , incidence (geometry) , transplantation , gastroenterology , antibody , immunology , kidney transplantation , physics , optics
Although large retrospective studies have identified the presence of donor‐specific antibodies (DSAs) to be a risk factor for rejection and impaired survival after liver transplantation, the long‐term predicted pathogenic potential of individual DSAs after liver transplantation remains unclear. We investigated the incidence, prevalence and consequences of DSAs in maintenance liver transplant (LT) recipients. Two hundred sixty‐seven LT recipients, who had undergone transplantation at least 6 months previously and had been screened for DSAs at least twice using single‐antigen bead technology, were included and tested annually for the presence of DSAs. At a median of 51 months (min–max: 6–220) after an LT, 13% of patients had DSAs. At a median of 36.5 months (min–max: 2–45) after the first screening, 9% of patients have developed de novo DSAs. The sole predictive factor for the emergence of de novo DSAs was retransplantation (OR 3.75; 95% CI 1.28–11.05, p = 0.025). Five out of 21 patients with de novo DSAs (23.8%) developed an antibody‐mediated rejection. Fibrosis score was higher among patients with DSAs. In conclusion, monitoring for the development of DSAs in maintenance LT patients is useful in case of graft dysfunction and to identify patients with a high risk of developing liver fibrosis.